Sarcoidosis - osseous involvement

Discussion:

Path proven sarcoidosis

Osseous involvement with sarcoidosis is rare (~1-13%), however when it occurs it is common in the hands, and classically presents with a honeycomb/latticework trabecular pattern, as is seen in this case. Acroosteolysis with or without sclerosis may also be seen. 

Spina ventosa of tuberculosis and other granulomatous infections would be reasonable differential considerations in this case, however the findings seen here are quite characteristic for sarcoidosis. Other differential thoughts include the cyst-like foci seen in tuberous sclerosis, enchondromatosisfibrous dysplasia, musculoskeletal hemangiomatosis and hyperparathyroidism

 

Case images courtesy of Jamie Bedle, DC, DACBR. 

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