Walsh & Hoyt: Sarcoidosis: Skeletal Manifestations

Osteal granulomas occur in about 3% of patients with sarcoidosis, almost always those with chronic disease. The small bones of the hands and feet are affected most often. Clinical manifestations include swelling and tenderness of the affected bones with overlying changes inthe skinas discussed above. Other bones, such as the vertebrae and long bones are affected much less frequently. Sarcoidosis of the skull also is rare and may be manifested either by a single radiolucent defect resembling the lesion of eosinophilic granuloma (i.e., Langerhans cell histiocytosis) or by multiple osteolytic defects similar to those seen in multiple myeloma and metastatic malignancy