title: [Swelling of the finger as initial manifestation of sarcoidosis].
abstract: BACKGROUND
  An extensive differential diagnosis exists for swelling of the fingers. One of the rare causes of such a swelling is a multisystem disorder called sarcoidosis.
  
  
  METHODS
  We describe a 40-year-old female patient who was first seen at our outpatient clinic with a painless swelling of the middle phalanx of her right middle finger. The diagnosis initially made was enchondroma, which was treated conservatively. Thirteen years later, the patient returned with pain and progressive swelling of this same finger. Physical examination and imaging revealed a giant-cell tumour of the tendon sheath, which was excised. The diagnosis of sarcoidosis was made after histological analysis.
  
  
  CONCLUSIONS
  The initial manifestation of sarcoidosis is rarely observed in bone and soft tissue. For this reason, symptoms arising from such tissues will not always lead to the consideration of this diagnosis. The typical radiological abnormalities of bone combined with swelling of soft tissue should, however, give rise to the consideration of this diagnosis.
authors.affiliation: Onze Lieve Vrouwe Gasthuis, Afd. Orthopedie, Amsterdam, the Netherlands. s.j.ham@olvg.nl
authors.forename: S J John
authors.initials: SJ
authors.lastname: Ham
authors.forename: Paavo L
authors.initials: PL
authors.lastname: Freijzer
authors.forename: Robert C J
authors.initials: RC
authors.lastname: Kanhai
authors.forename: Henk-Jan
authors.initials: HJ
authors.lastname: van der Woude
mesh_terms: D000328:Adult; D002812:Chondroma / Q000175:diagnosis / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005385:Fingers / Q000473:pathology* / Q000601:surgery; D005870:Giant Cell Tumors / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D012507:Sarcoidosis / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013710:Tendons / Q000473:pathology; D016896:Treatment Outcome