Disconcerting Sarcoidosis, When The Spine Gets Involved...
DOI:
https://doi.org/10.59667/sjoranm.v21i1.22Keywords:
bone sarcoidosis, inflammatory back pain, spinal MRIAbstract
Introduction: Osseous involvement in sarcoidosis can cause inflammatory back pain and may resemble malignant disease on imaging.
Observation: A 52-year-old woman with chronic cough and basithoracic pain had mediastinal-hilar lymphadenopathy and perilymphatic pulmonary nodules on chest CT. The diagnosis of sarcoidosis was supported by an iliac lymph node biopsy showing an epithelioid-giant cell granuloma. She also had intense inflammatory back pain, sometimes causing insomnia. Spinal MRI showed multiple nodular marrow lesions with low T1 signal and enhancement after gadolinium administration. The case report describes rib fractures, while bone densitometry was normal.
Conclusion: MRI demonstrated the extent of skeletal involvement but did not independently establish the cause of the lesions. Findings should be interpreted together with the clinical and histological evidence. Persistent inflammatory spinal pain in sarcoidosis warrants assessment of skeletal involvement and multidisciplinary discussion of treatment.
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