Sarcoidosis and sacroiliitis, a case report

Briongos-Figuero, Laisa Socorro; Ruíz-de-Temiño, Ángela; Pérez‐Castrillón, José Luis

doi:10.1007/s00296-011-2100-y

Cited by 6 publications

(3 citation statements)

References 8 publications

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“…There are rare reports of sarcoidosis coexisting with spondyloarthropathy [36, 42, 43]. Biopsy of the SI joint in sarcoid cases demonstrates non-caseating granulomata in the synovium [44, 45]; however, non-specific inflammatory changes have been described [39]. Even with biopsy changes consistent with sarcoid, tuberculous infection must be ruled out as well.…”

Section: Discussionmentioning

confidence: 99%

Sacroiliitis mimics: a case report and review of the literature

Antonelli

Magrey

2017

BMC Musculoskelet Disord

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BackgroundRadiographic sacroiliitis is the hallmark of ankylosing spondylitis (AS), and detection of acute sacroiliitis is pivotal for early diagnosis of AS. Although radiographic sacroiliitis is a distinguishing feature of AS, sacroiliitis can be seen in a variety of other disease entities.Case presentationWe present an interesting case of sacroiliitis in a patient with Paget disease; the patient presented with inflammatory back pain which was treated with bisphosphonate. This case demonstrates comorbidity with Paget disease and possible ankylosing spondylitis. We also present a review of the literature for other cases of Paget involvement of the sacroiliac joint.ConclusionsIn addition, we review radiographic changes to the sacroiliac joint in classical ankylosing spondylitis as well as other common diseases. We compare and contrast features of other diseases that mimic sacroiliitis on a pelvic radiograph including Paget disease, osteitis condensans ilii, diffuse idiopathic skeletal hyperostosis, infections and sarcoid sacroiliitis. There are some features in the pelvic radiographic findings which help distinguish among mimics, however, one must also rely heavily on extra-pelvic radiographic lesions. In addition to the clinical presentation, various nuances may incline a clinician to the correct diagnosis; rheumatologists should be familiar with the imaging differences among these diseases and classic spondylitis findings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-017-1525-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Sacroiliitis mimics: a case report and review of the literature

Antonelli

Magrey

2017

BMC Musculoskelet Disord

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“…Fever is usually absent or low grade • Risk factors: IV drug use, pelvic trauma, infectious endocarditis, immunosuppression, cutaneous or genitourinary infection • Imaging: on MRI, unilateral periarticular muscle edema, thick capsulitis, and extracapsular fluid collection may be useful in differentiating infectious sacroiliitis from sacroiliitis due to axSpA Whipple disease [152][153][154][155][156][157][158][159][160][161] • Large joint migratory arthralgias, abdominal pain, weight loss, and diarrhea, with or without IBP • Risk factors: occupational exposure to soil or animals • Imaging: sacroiliitis and spondylitis indistinguishable from axSpA Familial Mediterranean fever 143,[162][163][164] • Intermittent fevers, abdominal pain, large joint arthritis, enthesitis, IBP. Childhood or adolescent onset is typical, but may occur in adulthood • Risk factors: genetics (MEFV gene mutations); Turkish, Armenian, North African, Jewish, and Arab descent • Imaging: sacroiliitis indistinguishable from axSpA Sarcoidosis 149,[165][166][167][168][169][170] • IBP • Risk factors: sacroiliitis may occur most frequently in sarcoidosis limited to the thorax (thoracic lymph nodes and lungs) • Imaging: sacroiliitis indistinguishable from axSpA Spinal calcium pyrophosphate deposition disease [171][172][173] • Periodic IBP with elevated inflammatory markers • Risk factors: widespread peripheral chondrocalcinosis • Imaging: linear calcium deposition in intervertebral disks, SIJs, and/or peripheral joints Idiopathic hypoparathyroidism [174][175][176][177][178] • Hypocalcemia presentation ± back pain experience little or no pain relief with NSAIDs. 123 Furthermore, the sites of maximal point tenderness with fibromyalgia are usually not located precisely at entheseal sites.…”

Section: Fibromyalgiamentioning

confidence: 99%

“…Sacroiliac joint involvement in sarcoidosis often occurs with a history of IBP but may present in patients with mechanical back pain 149,168 . Radiographic evidence of sacroiliitis in sarcoidosis may be similar to that of AS; a biopsy of the SIJ may reveal noncaseating granulomata in the synovium, but SIJ biopsy is usually unnecessary if a sarcoidosis diagnosis can be made via clinical presentation or biopsy of extra-articular tissue 169 . Sacroiliitis may occur most frequently in sarcoidosis limited to the thorax 170 …”

Section: Sarcoidosismentioning

confidence: 99%

Clinical Manifestations and Diagnosis of Axial Spondyloarthritis

Walsh

Magrey

2020

J Clin Rheumatol

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Background Axial spondyloarthritis (axSpA) is a chronic, rheumatic disease characterized by inflammation of the sacroiliac joint, spine, and entheses. Axial spondyloarthritis affects up to 1.4% of adults in the United States and is associated with decreased quality of life, increased mortality, and substantial health care–related costs, imposing a high burden on patients, their caregivers, and society. Summary of Work Diagnosing axSpA can be difficult. In this review, we seek to help rheumatologists in recognizing and diagnosing axSpA. Major Conclusions A discussion of challenges associated with diagnosis is presented, including use and interpretation of imaging, reasons for diagnostic delays, differences in disease presentation by sex, and differential diagnoses of axSpA. Future Research Directions The early diagnosis of axSpA and advances in available therapeutic options have improved patient care and disease management, but delays in diagnosis and treatment remain common. Additional research and education are critical for recognizing diverse axSpA presentations and optimizing management early in the course of disease.

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Spondyloarthritis and sarcoidosis: Related or fake friends? A systematic literature review

et al. 2020

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Highlights Spondyloarthritis and sacroiliitis are regularly associated to sarcoidosis, especially in cases of inflammatory back pain  A granulomatous involvement of pelvic bones in sarcoidosis can occur and mimic sacroiliitis;unilateral changes on X-rays are suggestive of granulomatous involvement.  True sacroiliac joint arthropathy associated to sarcoidosis is still matter of discussion.  Imaging modalities used to evaluate sacroiliac joint in sarcoidosis are still heterogeneous.

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Sarcoidosis and sacroiliitis, a case report

Abstract: Sarcoidosis is a multisystem disorder of unknown etiology characterized by the presence of non-caseating granulomas in the organs affected. Sarcoid arthropathy is a rare manifestation, and sacroiliitis is an unusual first manifestation of the disorder

Cited by 6 publications

References 8 publications

Sacroiliitis mimics: a case report and review of the literature

Sacroiliitis mimics: a case report and review of the literature

Clinical Manifestations and Diagnosis of Axial Spondyloarthritis

Spondyloarthritis and sarcoidosis: Related or fake friends? A systematic literature review

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