Skeletal Radiology

, Volume 45, Issue 5, pp 717–721 | Cite as

Sarcoidosis: radiographic manifestations in the nails and distal phalanges

  • Brittany K. Albers
  • Jason C. Sluzevich
  • Hillary W. Garner
Case Report


Sarcoidosis is a granulomatous disease which can affect multiple organ systems. Clinical and radiologic manifestations depend on the organ system involved and the chronicity of disease. Nail involvement in sarcoidosis is rare, but is clinically relevant as it indicates chronic systemic disease. Nail abnormalities can be identified radiographically, and when seen in patients with known or suspected sarcoidosis, should prompt careful evaluation of the underlying bone for osseous involvement. We describe a case of sarcoidosis with radiographic findings in the nails and distal phalangeal tufts, which were indicative of nail and osseous sarcoid involvement and strongly supported the presence of chronic systemic disease. Although the nail findings resolved clinically and on radiographs after treatment, the osseous findings showed only minimal improvement. To our knowledge, the radiographic findings of nail sarcoidosis have not been previously addressed in the literature.


Sarcoidosis Nail Bone Hand Radiographs 


Compliance with ethical standards

Conflict of interest

No conflict of interest.


  1. 1.
    O’Regan A, Berman JS. Sarcoidosis. Ann Intern Med. 2012;156(9):ITC5, 1–16.Google Scholar
  2. 2.
    Rao DA, Dellaripa PF. Extrapulmonary manifestations of sarcoidosis. Rheum Dis Clin N Am. 2013;39(2):277–97.CrossRefGoogle Scholar
  3. 3.
    Kobak S. Sarcoidosis: a rheumatologist’s perspective. Ther Adv Musculoskelet Dis. 2015;7(5):196–205.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Balan A, Hoey ETD, Sheerin F, Lakkaraju A, Chowdhury FU. Multi-technique imaging of sarcoidosis. Clin Radiol. 2010;65(9):750–60.CrossRefPubMedGoogle Scholar
  5. 5.
    Koyama T, Ueda H, Togashi K, Umeoka S, Kataoka M, Nagai S. Radiologic manifestations of sarcoidosis in various organs. RadioGraphics. 2004;24(1):87–104.CrossRefPubMedGoogle Scholar
  6. 6.
    Santoro F, Sloan SB. Nail dystrophy and bony involvement in chronic sarcoidosis. J Am Acad Dermatol. 2009;60(6):1050–2.CrossRefPubMedGoogle Scholar
  7. 7.
    Fernandez-Faith E, McDonnell J. Cutaneous sarcoidosis: differential diagnosis. Clin Dermatol. 2007;25(3):276–87.CrossRefPubMedGoogle Scholar
  8. 8.
    Momen SE, Al-Niaimi F. Sarcoid and the nail: review of the literature. Clin Exp Dermatol. 2013;38(2):119–24. quiz 125.CrossRefPubMedGoogle Scholar
  9. 9.
    Wanat K, Rosenbach M. A practical approach to cutaneous sarcoidosis. Am J Clin Dermatol. 2014;15:283–97.CrossRefPubMedGoogle Scholar
  10. 10.
    Baughman RP, Teirstein AS, Judson MA, et al. Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med. 2001;164(10):1885–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Sparks JA, McSparron JI, Shah N, Aliabadi P, Paulson V, Fanta CH, et al. Osseous sarcoidosis: clinical characteristics, treatment, and outcomes—experience from a large, academic hospital. Semin Arthritis Rheum. 2014;44(3):371–9.CrossRefPubMedGoogle Scholar
  12. 12.
    Moore SL, Teirstein A, Golimbu C. MRI of sarcoidosis patients with musculoskeletal symptoms. AJR Am J Roentgenol. 2005;185(1):154–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Veien NK, Stahl D, Brodthagen H. Cutaneous sarcoidosis in Caucasians. J Am Acad Dermatol. 1987;16(3 Pt 1):534–40.CrossRefPubMedGoogle Scholar
  14. 14.
    Patel KB, Sharma OP. Nails in sarcoidosis: response to treatment. Arch Dermatol. 1983;119(4):277–8.CrossRefPubMedGoogle Scholar
  15. 15.
    Vagal AS, Shipley R, Meyer CA. Radiological manifestations of sarcoidosis. Clin Dermatol. 2007;25(3):312–25.CrossRefPubMedGoogle Scholar
  16. 16.
    Grover C, Chaturvedi UK, Reddy BS. Role of nail biopsy as a diagnostic tool. Indian J Dermatol Venereol Leprol. 2012;78(3):290–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Shorr AF, Murphy FT, Gilliland WR, Hnatiuk W. Osseous disease in patients with pulmonary sarcoidosis and musculoskeletal symptoms. Respir Med. 2000;94(3):228–32.CrossRefPubMedGoogle Scholar
  18. 18.
    Haimovic A, Sanchez M, Judson MA, Prystowsky S. Sarcoidosis: a comprehensive review and update for the dermatologist: part I, cutaneous disease. J Am Acad Dermatol. 2012;66(5):699.e1–18.CrossRefGoogle Scholar
  19. 19.
    Kuzyshyn H, Feinstein D, Kolasinski SL, Eid H. Osseous sarcoidosis: a case series. Rheumatol Int. 2014.Google Scholar

Copyright information

© ISS 2016

Authors and Affiliations

  • Brittany K. Albers
    • 1
  • Jason C. Sluzevich
    • 2
  • Hillary W. Garner
    • 1
  1. 1.Department of RadiologyMayo ClinicJacksonvilleUSA
  2. 2.Department of DermatologyMayo ClinicJacksonvilleUSA

Personalised recommendations