Osteoarticular involvement in a series of 100 patients with sarcoidosis referred to rheumatology departments.
OBJECTIVE
To analyze the pattern of osteoarticular lesions in patients with sarcoidosis hospitalized in 4 rheumatology departments.


METHODS
We carried out a systematic retrospective analysis of cases with sarcoidosis admitted in the last 10 years, using hospital databases. Two distinct groups were defined from the outset: patients with Löfgren's syndrome (LS) or sarcoid rheumatism (SR). We assessed the following items: distribution of arthritis, chronicity, systemic manifestations, biochemical and immunological measures.


RESULTS
We included 100 patients (75% women); 43% had LS and 57% SR. Osteoarticular symptoms revealed the disease in 85% of patients. The patients in the LS group were younger than those in the SR group (41 +/- 9 vs 48 +/- 13 yrs; p < 0.006) and were more likely to have oligoarthritis involving ankles (58% vs 32%; p = 0.04) and high C-reactive protein concentrations (63% vs 33%; p < 0.005). Patients with SR presented osteoarticular symptoms in the form of oligoarthritis (32%), polyarthritis (32%), bony erosion in 8/57 (14%), and osteitis in 9/57 (16%). Lung interstitial involvement was more frequent in the SR group than in the LS group (38% vs 18%; p = 0.03). Chronic polyarthritis was associated with the detection of rheumatoid factor (p = 0.004). Osteitis occurred in older patients (p = 0.02).


CONCLUSIONS
SR was the most frequent manifestation leading to hospitalization; it was characterized by oligoarthritis and polyarthritis and associated with interstitial lung involvement. Osseous involvement occurred in a quarter of SR patients with similar frequency of erosions targeting the distal small bones and osteitis. These latter occurred at a later age.
Thelier
Natacha
N
Department of Rheumatology A, Paris Descartes University, Paris, France.
Assous
Noémie
N
Job-Deslandre
Chantal
C
Meyer
Olivier
O
Bardin
Thomas
T
Orcel
Philippe
P
Lioté
Frédéric
F
Dougados
Maxime
M
Kahan
Andre
A
Allanore
Yannick
Y
D000328:Adult; D001168:Arthritis / Q000150:complications*; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007596:Joints / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000150:complications; D008297:Male; D008875:Middle Aged; D010000:Osteitis / Q000150:complications* / Q000473:pathology*; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000150:complications* / Q000473:pathology*; D013577:Syndrome