This is the first attempt to assess the distribution and extent of musculoskeletal changes in patients with sarcoidosis by whole-body MRI (wbMRI) and correlate the findings with laboratory and lung function data.
Methods and Materials
Twenty-four consecutive patients with histologically confirmed sarcoidosis were prospectively enrolled in this study.
Patients were recruited regardless of specific treatment and apparent extrapulmonary involvement.
A pregnancy test was performed in all women of childbearing age.
In order to estimate the extrapulmonary activity of sarcoidosis the extrapulmonary physician organ severity tool (ePOST) was employed.
Full blood count and a metabolic laboratory panel including creatine kinase,
bilirubin and alkaline phosphatase were performed.
serum levels of ACE and sIL-2R as well as calcium in 24-hour...
WbMRI showed changes in all 24 (100%) patients.
In 8/24 (33%) patients lesions with confidence level 2 and 1 were noted (Fig.
5/24 (21%) patients showed skeletal lesions,
one patient having a disseminated edema-like skeletal manifestation highly probable of sarcoidal origin.
Muscular findings were seen in 3/24 (13%) patients,
one of which had a nodular lesion histologically proven to be a sarcoid nodule.
The cases with MR-findings of confidence 2 and 1 had a higher mean ePOST score (17.3 vs.
In a sample of consecutive sarcoidosis patients,
wbMRI depicted musculoskeletal manifestations potentially related to sarcoidosis in one third of cases,
which had significantly higher ePOST scores.
Impaired lung function correlated with a higher occurrence of abnormal wbMRI skeletal findings.
Whole body MRI might be a useful tool to assess extrapulmonary disease activity and abnormal skeletal MR-findings might be a marker of total disease activity.
Moore SL et al.
Can sarcoidosis and metastatic bone lesions be reliably differentiated on routine MRI? Am J Roentgenol. 2012 Jun;198(6):1387-93