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Sarcoidosis of Bone
Donna G. Blankenbaker, MD, FACR; Sandra Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Definitions

            • Inflammatory disorder of unknown cause resulting in noncaseating granulomatous deposits involving any organ or tissue
              • Lungs/lymph nodes most frequently affected
              • Wide variety of musculoskeletal manifestations
                • Bone, muscle, joint, soft tissue; bone discussed in this chapter

          IMAGING

          • General Features

            • Imaging Recommendations

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          Selected References

                                          1. Patil S et al: Musculoskeletal sarcoidosis: a single center experience over 15 years. Int J Rheum Dis. 24(4):533-41, 2021
                                          2. Papiris SA et al: Prevalence, distribution and clinical significance of joints, muscles and bones in sarcoidosis: an 18F-FDG-PET/CT study. Expert Rev Respir Med. 14(9):957-64, 2020
                                          3. Ben Hassine I et al: Osseous sarcoidosis: a multicenter retrospective case-control study of 48 patients. Joint Bone Spine. 86(6):789-93, 2019
                                          4. Brandão Guimarães J et al: Radiologic manifestations of musculoskeletal sarcoidosis. Curr Rheumatol Rep. 21(3):7, 2019
                                          5. Akaike G et al: PET/CT in the diagnosis and workup of sarcoidosis: focus on atypical manifestations. Radiographics. 38(5):1536-49, 2018
                                          6. Bechman K et al: A review of the musculoskeletal manifestations of sarcoidosis. Rheumatology (Oxford). 57(5):777-83, 2018
                                          7. Ganeshan D et al: Sarcoidosis from head to toe: what the radiologist needs to know. Radiographics. 38(4):1180-200, 2018
                                          8. Lew PP et al: Imaging of disorders affecting the bone and skin. Radiographics. 34(1):197-216, 2014
                                          9. Vardhanabhuti V et al: Sarcoidosis--the greatest mimic. Semin Ultrasound CT MR. 35(3):215-24, 2014
                                          10. Moore SL et al: Can sarcoidosis and metastatic bone lesions be reliably differentiated on routine MRI? AJR Am J Roentgenol. 198(6):1387-93, 2012
                                          11. Baldini S et al: PET positivity with bone marrow biopsy revealing sarcoidosis in a patient in whom bone marrow metastases had been suspected. Br J Haematol. 143(3):306, 2008
                                          12. Simpfendorfer CS et al: Does the presence of focal normal marrow fat signal within a tumor on MRI exclude malignancy? An analysis of 184 histologically proven tumors of the pelvic and appendicular skeleton. Skeletal Radiol. 37(9):797-804, 2008
                                          13. Talmi D et al: Central skeletal sarcoidosis mimicking metastatic disease. Skeletal Radiol. 37(8):757-61, 2008
                                          14. Thelier N et al: Osteoarticular involvement in a series of 100 patients with sarcoidosis referred to rheumatology departments. J Rheumatol. 35(8):1622-8, 2008
                                          15. Iannuzzi MC et al: Sarcoidosis. N Engl J Med. 357(21):2153-65, 2007
                                          16. Moore SL et al: MRI of sarcoidosis patients with musculoskeletal symptoms. AJR Am J Roentgenol. 185(1):154-9, 2005
                                          17. Aberg C et al: FDG positron emission tomography of bone involvement in sarcoidosis. AJR Am J Roentgenol. 182(4):975-7, 2004
                                          18. Moore SL et al: Musculoskeletal sarcoidosis: spectrum of appearances at MR imaging. Radiographics. 23(6):1389-99, 2003
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Definitions

                                                    • Inflammatory disorder of unknown cause resulting in noncaseating granulomatous deposits involving any organ or tissue
                                                      • Lungs/lymph nodes most frequently affected
                                                      • Wide variety of musculoskeletal manifestations
                                                        • Bone, muscle, joint, soft tissue; bone discussed in this chapter

                                                  IMAGING

                                                  • General Features

                                                    • Imaging Recommendations

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Nuclear Medicine Findings

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    • Gross Pathologic & Surgical Features

                                                                      • Microscopic Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Consider

                                                                                  Selected References

                                                                                  1. Patil S et al: Musculoskeletal sarcoidosis: a single center experience over 15 years. Int J Rheum Dis. 24(4):533-41, 2021
                                                                                  2. Papiris SA et al: Prevalence, distribution and clinical significance of joints, muscles and bones in sarcoidosis: an 18F-FDG-PET/CT study. Expert Rev Respir Med. 14(9):957-64, 2020
                                                                                  3. Ben Hassine I et al: Osseous sarcoidosis: a multicenter retrospective case-control study of 48 patients. Joint Bone Spine. 86(6):789-93, 2019
                                                                                  4. Brandão Guimarães J et al: Radiologic manifestations of musculoskeletal sarcoidosis. Curr Rheumatol Rep. 21(3):7, 2019
                                                                                  5. Akaike G et al: PET/CT in the diagnosis and workup of sarcoidosis: focus on atypical manifestations. Radiographics. 38(5):1536-49, 2018
                                                                                  6. Bechman K et al: A review of the musculoskeletal manifestations of sarcoidosis. Rheumatology (Oxford). 57(5):777-83, 2018
                                                                                  7. Ganeshan D et al: Sarcoidosis from head to toe: what the radiologist needs to know. Radiographics. 38(4):1180-200, 2018
                                                                                  8. Lew PP et al: Imaging of disorders affecting the bone and skin. Radiographics. 34(1):197-216, 2014
                                                                                  9. Vardhanabhuti V et al: Sarcoidosis--the greatest mimic. Semin Ultrasound CT MR. 35(3):215-24, 2014
                                                                                  10. Moore SL et al: Can sarcoidosis and metastatic bone lesions be reliably differentiated on routine MRI? AJR Am J Roentgenol. 198(6):1387-93, 2012
                                                                                  11. Baldini S et al: PET positivity with bone marrow biopsy revealing sarcoidosis in a patient in whom bone marrow metastases had been suspected. Br J Haematol. 143(3):306, 2008
                                                                                  12. Simpfendorfer CS et al: Does the presence of focal normal marrow fat signal within a tumor on MRI exclude malignancy? An analysis of 184 histologically proven tumors of the pelvic and appendicular skeleton. Skeletal Radiol. 37(9):797-804, 2008
                                                                                  13. Talmi D et al: Central skeletal sarcoidosis mimicking metastatic disease. Skeletal Radiol. 37(8):757-61, 2008
                                                                                  14. Thelier N et al: Osteoarticular involvement in a series of 100 patients with sarcoidosis referred to rheumatology departments. J Rheumatol. 35(8):1622-8, 2008
                                                                                  15. Iannuzzi MC et al: Sarcoidosis. N Engl J Med. 357(21):2153-65, 2007
                                                                                  16. Moore SL et al: MRI of sarcoidosis patients with musculoskeletal symptoms. AJR Am J Roentgenol. 185(1):154-9, 2005
                                                                                  17. Aberg C et al: FDG positron emission tomography of bone involvement in sarcoidosis. AJR Am J Roentgenol. 182(4):975-7, 2004
                                                                                  18. Moore SL et al: Musculoskeletal sarcoidosis: spectrum of appearances at MR imaging. Radiographics. 23(6):1389-99, 2003