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18F-FDG PET/CT in bone sarcoidosis: an observational study

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Abstract

Objective

Bone sarcoidosis is usually rare. Imaging procedures such as fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) can reveal bone sarcoidosis with better sensitivity than conventional radiography. We aimed to describe bone sarcoidosis involvement detected with 18F-FDG PET/CT.

Methods

This was an observational retrospective study of individuals with pulmonary sarcoidosis who underwent 18F-FDG PET/CT. According to the ATS/ERS/WASOG criteria, sarcoidosis was diagnosed by the presence of clinical and/or imaging features of sarcoidosis and evidence of non-caseating epithelioid granulomas on a biopsy. We assessed clinical and 18F-FDG PET/CT characteristics.

Results

Data for 85 patients with sarcoidosis (56.5% female, median age 47 [range 21–80] years) were analyzed. The median follow-up was 4 years. Among 56 patients, sarcoidosis occurred in more than three organs. According to ATS/ERS/WASOG criteria, bone sarcoidosis was diagnosed in 12 (14%) patients. The spine was the most commonly affected location (92%, n = 11), followed by the pelvis (67%, n = 8), sternum (33%, n = 4), humerus (25%, n = 3), and fingers (17%, n = 2). Only peripheral adenopathy was associated with bone sarcoidosis (p = 0.04). Seven patients had a 18F-FDG PET/CT follow-up, all showing a decrease of bone lesions.

Conclusion

Bone sarcoidosis occurred in 14% of patients with sarcoidosis, affecting multiple bones and mostly the axial skeleton. 18F-FDG PET/CT seems a sensitive tool for diagnosis and follow-up of bone sarcoidosis.

Key Points

• Bone sarcoidosis is not rare.

• Bone sarcoidosis affects mainly the axial skeleton.

• 18F-FDG PET/CT is useful for diagnosis and follow-up of bone sarcoidosis.

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Acknowledgments

We thank Laura Smales (BioMedEditing) for copyediting.

b X-rays of fingers. Presence of an enlargement of the feeder holes (asterisk) of phalanges associated with a mesh appearance (long white arrow), acro-osteolysis (circle), pseudocystic lesions eroding the cortex and extensive osteolysis with fracture (arrowhead).

c Finger bone involvement seen on 18F-FDG PET

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Authors and Affiliations

  1. AP-HP, Hôpital Bichat-Claude Bernard, Service de Rhumatologie, 46 rue Henri Huchard, 75018, Paris, France

    Lucie Demaria, Julia Goossens, Elisabeth Palazzo, Marine Forien, Philippe Dieudé & Sébastien Ottaviani

  2. AP-HP, Hôpital Bichat-Claude Bernard, Service de Pneumologie, Paris, France

    Raphael Borie & Bruno Crestani

  3. AP-HP, Hôpital Bichat-Claude Bernard, Service de Médecine Nucléaire, Paris, France

    Khadija Benali & Eve Piekarski

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  1. Lucie Demaria
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  2. Raphael Borie
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  10. Sébastien Ottaviani
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Correspondence to Sébastien Ottaviani.

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Demaria, L., Borie, R., Benali, K. et al. 18F-FDG PET/CT in bone sarcoidosis: an observational study. Clin Rheumatol 39, 2727–2734 (2020). https://doi.org/10.1007/s10067-020-05022-6

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  • DOI: https://doi.org/10.1007/s10067-020-05022-6

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