Musculoskeletal involvement in sarcoidosis

Abstract

Sarcoidosis is a multisystem inflammatory disorder of unknown cause. It most commonly affects the pulmonary system but can also affect the musculoskeletal system, albeit less frequently. In patients with sarcoidosis, rheumatic involvement is polymorphic. It can be the presenting symptom of the disease or can appear during its progression. Articular involvement is dominated by nonspecific arthralgia, polyarthritis, and Löfgren's syndrome, which is defined as the presence of lung adenopathy, arthralgia (or arthritis), and erythema nodosum. Skeletal manifestations, especially dactylitis, appear mainly as complications of chronic, multiorgan sarcoidosis. Muscle involvement in sarcoidosis is rare and usually asymptomatic. The diagnosis of rheumatic sarcoidosis is based on X-ray findings and magnetic resonance imaging findings, although the definitive diagnosis is made by anatomopathological study of biopsy samples. Musculoskeletal involvement in sarcoidosis is generally relieved with nonsteroidal anti-inflammatory drugs or corticosteroids. In corticosteroid-resistant or -dependent forms of the disease, immunosuppressive therapy, such as treatment with methotrexate or anti-TNF-α, is employed. The aim of this review was to present an overview of the various types of osteoarticular and muscle involvement in sarcoidosis, focusing on their diagnosis and management.

Principles of Rehabilitation and Reactivation: Interstitial Lung Disease, Sarcoidosis and Rheumatoid Disease with Respiratory Involvement

“…The impact of corticosteroids in sarcoidosis is less clear, with conflicting findings regarding its impact on quadriceps force [26,27]. These contrasting findings may be related to the underlying cause of myopathy; muscle sarcoidosis is rare, but typically responds well to systematic corticosteroid treatment [35], whereas steroid-induced myopathy may occur in other patients using corticosteroids to treat other disease manifestations. In SSc, skeletal muscle dysfunction is worse in those with longer disease duration, and in those with diffuse cutaneous SSc compared to limited cutaneous SSc [36].…”

Sarcoidosis of the Mandibular Condyle: A Rare Disease That Can Mimic Malignancy

“…2 The radiographic finding is pathognomonic in a patient with a confirmed diagnosis of sarcoidosis. 2,3 Large bone sarcoidosis is often occult on radiographs although it can present as a lytic or sclerotic lesion, or both. Due to the nonspecific radiographic appearance in large bones, it is difficult to differentiate osseous sarcoidosis from other diseases including osseous metastases or myeloma.…”

“…Medical treatment is reserved for symptomatic patients and combined with the treatment for systemic sarcoidosis. 1,3,4…”

“…Osseous sarcoidosis is rare, reported in 5-10% of all the sarcoidoses. [2][3] It is usually found in short bones like phalanges of the hands and feet. Patients are usually asymptomatic, but can present with bone pain or chronic polyarthritis.…”

Sternoclavicular joint arthritis as the initial presentation of sarcoidosis

“…With the exception of Löfgren syndrome, joint manifestations are rarely observed at symptom onset in sarcoidosis (6). Acute arthritis in Löf-gren syndrome is usually oligoarticular, can be polyarticular or rarely, monoarticular (3,5,7).…”