Osseous sarcoidosis: Clinical characteristics, treatment, and outcomes—Experience from a large, academic hospital

Bone and bone marrow involvement in sarcoidosis

“…It remains unclear why the bone is involved in sarcoidosis. The small bones of the hands and feet are typically affected [6][7][8]. However, involvement of other bones, such as long bones and axial skeleton, is not uncommon with the use of advanced imaging, as illustrated in our cases series.…”

“…Two patients were symptomatic from osseous sarcoidosis; one was thought to be symptomatic from his meniscal tear. In a recent large series from an academic hospital, symptoms were present in 50 % (10/20) of cases [7]. Despite multiple affected bones in all three patients, serum calcium level was only slightly elevated in one patient, reflecting a distinct pathophysiology compared to other diseases that affect bones.…”

“…These modalities can demonstrate the overall osseous sarcoid burden, similar to the 'staging' approach in managing patients with metastatic disease. It is currently unclear how often asymptomatic sarcoid bone lesions are incidentally detected in PET imaging [7]. Mostard et al [10] showed that more than one-third (32/94) of PET-CT-positive sarcoidosis patients had osseous abnormalities on PET-CT; however, there was no single preference of bone localization.…”

“…In the largest series describing osseous sarcoidosis [7], 11 patients (55 %) required no treatment; 9 (45 %) were treated, most often with prednisone, methotrexate, or hydroxychloroquine. Two cases required multiple immunosuppressants, including tumor necrosis factor inhibitors, for refractory symptomatic osseous sarcoidosis.…”

En kvinne i 40-årene med bekkensmerter og uklare MR-funn

“…Beinmargsaffeksjon er sjelden, både som isolert manifestasjon eller som ledd i mer utbredt sykdom (14,15). En studie fra 2014 viste at i gruppen med beinmargsaffeksjon hadde 90 % affisert bekken og lumbosakralcolumna (16). Sarkoidose i beinmarg forekommer som oftest uten hematologiske avvik (17), som hos vår pasient.…”