<http://radiographics.rsnajnls.org/cgi/reprint/23/6/1389.pdf>
Found this great paper discussing musculoskeletal Sarc. Sarc can cause bursitis in the knees, feet, shoulders, etc. (All the joint pain and swelling) Most Rhuems use XRays to diagnose. Unfortunatley XRays typically don't show sarc very well so your XRay might look 'normal' when you actually have stuff going on. To really 'see' sarc, docs should be using MR (Magnetic Resonance) imaging.
Enjoy the read! You really need to read the paper located at the link, really good info.
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Except from paper: (click on link to read the whole thing.)
Magnetic resonance (MR) imaging reveals a broad range of musculoskeletal
abnormalities in patients with sarcoidosis, including focal and
diffuse muscle lesions, soft-tissue masses, joint abnormalities, and marrow
infiltration of small and large bones. Long bone and axial skeletal
involvement may be occult at conventional radiography but depicted at
MR imaging, with an appearance that resembles that of osseous metastases.
Sarcoidosis-related findings may be detected at dedicated MR
imaging for osteoarticular symptoms in sarcoidosis patients or encountered
incidentally at MR imaging performed for other indications. Correlation
with clinical and laboratory findings is essential for correct diagnosis
because the MR imaging findings are nonspecific in most
cases. The radiologist should be aware of potential sarcoidal causes in
the differential diagnosis of musculoskeletal lesions in patients with
proved or suspected sarcoidosis. Such consideration will have a profound
effect on the interpretation of images and on the study of patients
with dual diagnoses of sarcoidosis and neoplasm.
Introduction
Sarcoidosis is an inflammatory disorder of unknown
cause that is characterized by the presence
of noncaseating granulomas in tissues, with no
evidence of other known causes of granulomatous
disease. Sarcoidosis involves multiple organs,
most commonly the lungs, lymph nodes, skin,
and eyes, but may be clinically evident in any organ
system, including the musculoskeletal system.
Skeletal involvement has been reported in 1%–
13% of sarcoidosis patients, with an estimated
average of 5% (1), a figure that is determined on
the basis of findings at conventional radiography
performed for the detection of bone disease. Although
sarcoidosis patients commonly complain
of bone and joint pain, imaging evaluation is often
limited to radiography of the hands or feet that
demonstrates either normal findings or lacelike
osteolysis. Osteosclerotic manifestations are also
seen, but infrequently. Involvement of the large
bones and axial skeleton is considered uncommon
and may not be evaluated with imaging.
Because of the excellent tissue contrast of magnetic
resonance (MR) imaging, musculoskeletal
abnormalities that are occult on radiographs may
be seen on MR images obtained in sarcoidosis
patients. These abnormalities include small and
large bone marrow infiltration, focal and diffuse
muscle lesions, soft-tissue infiltration, and
masses. Other nonspecific associated findings
seen at MR imaging include tendinopathy and
tenosynovitis. Radiologists should be cognizant of
the appearances, differential diagnoses, and extent
of musculoskeletal lesions that may be seen
at MR imaging in this patient population.
In this article, we present the spectrum of abnormalities
found in patients from our Sarcoidosis
Service who were referred for MR imaging
evaluation of musculoskeletal symptoms. These
abnormalities included osseous lesions (small and
large bone sarcoidosis), sarcoidal arthropathy,
and sarcoidal myopathy. All MR images were obtained
with a 1.5-T imager (Signa Horizon or
LX; GE Medical Systems, Milwaukee, Wis).
Click on link to read entire paper
http://radiographics.rsnajnls.org/cgi/reprint/23/6/1389.pdf
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