La Revue de medecine interne

• Published in: La revue de medecine interne Vol. 41; no. 12; pp. 846 - 851
• Main Authors: Escoda, T, Benyamine, A, Belenotti, P, Masson, E, Chemouni, D, Vaccaro, J, Gabriel, S, Swiader, L, Weiller, P J, Rossi, P, Granel, B
• Format: Journal Article
• Language: French
• Published: 01.12.2020
• ISSN: 1768-3122
• DOI: 10.1016/j.revmed.2020.07.008

INTRODUCTIONSarcoidosis is a multi-systemic disease characterized by non-caseating granulomas. Bone involvement initially considered as rare and described as a peripheral osteitis of the hands and feet, has recently been reported on the axial skeleton. CASE REPORTSWe report 4 clinical observations of sarcoidosis (3 women, 1 man) with axial bone involvement located to the spine (n = 4), pelvic bone (n = 2), scapular bone (n = 2), sternum (n = 1), mandible (n = 1). Sarcoidosis was already diagnosed in 3 cases. Bone pain was the main symptom, related in 3 cases. Magnetic resonance imaging appeared to be the best imaging test Histological bone analysis revealed typical granulomatous lesions (n = 2). Treatment included corticosteroids (n = 4), hydroxychloroquine (n = 2), and methotrexate (n = 2), with a good efficacy on bone pain in symptomatic patients. CONCLUSIONThese 4 cases, as well as recent literature, illustrate bone involvement of sarcoidosis on the axial skeleton. It is symptomatic in around 50% of cases but may be a source of significant disability. Differential diagnosis with neoplasm may require bone histological analysis. This condition appears to be responsive to usual treatments for sarcoidosis.