- Clinical Manifestations:
- may have fevers, rash, & iritis, which can resemble symptoms of JRA.
- pulmonary dz, erythema nodosum, abdominal pain, liver enlargement, and perihilar adenopathy may also be present.
- labs: elevated ACE serum level is considered to be the activity marker of the disease
- phalanges of the hand may contain large sacroid accumulation which may enlarge and deform the bone but do not
invade the soft tissue;
- most often involves distal and middle phalanx;
- pinched out osteolytic areas represent a concentration of granulation tissue which replace bone;
- coarse trabecular - lace like - presentation is also common;
- periosteal bone formation is generally not present;
- may cause extensor tendon synovitis or may involve the flexor tendon sheath;
- synovium will be nontender & boggy & does not limit ROM;
- Radiographic Studies:
- Ossification of Soft Tissue and Periosteum:
- perarticular metastatic calcification also occurs in disorders in which hypercalcemia predominates (eg.
milk alkali syndrome, sarcoidosis, and Vit D intoxication)
- ref: Images in Clinical Medicine. Sarcoid Arthropathy
Sarcoidosis of the Hand and Wrist: a report of two cases.