Prevalence, distribution and clinical significance of joints, muscles and bones in sarcoidosis: an 18F-FDG-PET/CT study. (1st September 2020)

• Record Type: Journal Article
• Authors: Papiris, Spyros A.; Manali, Effrosyni D.; Papaioannou, Andriana I.; Georgakopoulos, Alexandros; Kolilekas, Lykourgos; Pianou, Nikoletta K.; Kallergi, Maria; Papaporfyriou, Anastasia; Kallieri, Maria; Apollonatou, Vasiliki; Papadaki, Georgia; Malagari, Katerina; Kelekis, Nikolaos L.; Pneumatikos, Spyros G.; Chatziioannou, Sofia
• Is Part Of: Expert review of respiratory medicine. Volume 14:Number 9(2020)
• Page Start: 957
• Page End: 964
• Publication Date: 2020-09-01
• Subjects: Sarcoidosis -- joints -- muscles -- bones -- 18F-FDG-PET/CT; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Diseases -- Treatment -- Periodicals; 616.2005
• DOI: 10.1080/17476348.2020.1775587
• Languages: English
• ISSNs: 1747-6348

Abstract

ABSTRACT: Objectives: In Sarcoidosis joints-muscles-bones (JMBs) localizations are of the least common. 18 F-FDG-PET/CT imaging revolutionized detection of JMBs involvement by adding metabolic activity information and allowing for a comprehensive, whole-body mapping of the disease. Aim and methods: This study investigated prevalence, distribution, and clinical significance of JMBs sarcoidosis in 195 consecutive patients that underwent 18 F-FDG PET/CT examination. Results: Joint and bone involvement were encountered in 15% of patients with a mean of the maximum-standardized-uptake-value (SUVmax ) of 6.1. Most common location was the axial skeleton. Hypercalciuria was significantly more frequent in patients with osseous involvement (p = 0.003). Muscle activity (SUVmax = 2.4) was encountered in 20% of the patients, most frequently in treatment-naïve (p = 0.02). The muscles of the lower extremities were affected the most. Muscle and bone localization coexist in 50% of the cases. JMBs disease was almost asymptomatic, not related to chronicity but to pulmonary, nodal, and systemic disease. Long-term follow-up and treatment response of affected patients confirmed sarcoidosis. Conclusion: 18 F-FDG-PET/CT revealed JMBs localizations and coexistence with other organ sites supporting the concept that sarcoidosis is a systemic disease. By allowing an integrative interpretation of multi-organ involvement in the context of a pattern highly suggestive of sarcoidosis, it strongly keeps-off the diagnosis of malignancy.