Skip to main content
Log in

Sarcoidosis Presenting as a Proximal Phalangeal Bony Swelling—a Case and Review of the Literature

  • Case Reports
  • Published:
HAND

Abstract

We report a case of a 27-year-old man who presented with a progressive painful swelling at the base of his left index finger, with radiographs and a computed tomography scan revealing a lytic lesion of the proximal phalanx. Following further investigation, the patient underwent a bone biopsy that revealed a florid noncaseating granulomatous chronic inflammatory infiltrate, compatible with sarcoidosis. Osseous sarcoidosis of the hand is uncommon and, in the absence of significant systemic disease, is rarely the primary presenting feature. Early diagnosis and treatment of such undetermined bone pathology, via referral to a regional musculoskeletal tumor service, can prevent significant future complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6

References

  1. Cetinkaya R, Kavak A, Parlak AH, et al. Can sarcoidosis cause autoamputation of a finger phalanx? J Hand Surg [Br]. 2006;31:413–5. doi:10.1016/j.jhsb.2006.03.161.

    CAS  Google Scholar 

  2. DeSimone DP, Brilliant HL, Basile J, et al. Granulomatous infiltration of the talus and abnormal vitamin D and calcium metabolism in a patient with sarcoidosis: successful treatment with hydroxychloroquine. Am J Med. 1989;87:694–6.

    Article  CAS  PubMed  Google Scholar 

  3. Gibson GJ, Prescott RJ, Muers MF, et al. British Thoracic Society Sarcoidosis study: effects of long term corticosteroid treatment. Thorax. 1996;51:238–47. doi:10.1136/thx.51.3.238.

    Article  CAS  PubMed  Google Scholar 

  4. Imai S, Matsusue Y. Recurrent solitary sarcoidosis in bone—a case report. Acta Orthop Scand. 2003;74(5):626–8. doi:10.1080/00016470310018081.

    Article  PubMed  Google Scholar 

  5. James DG. Dermatological aspects of sarcoidosis. Q J Med. 1959;24:109–24.

    Google Scholar 

  6. Lopez DV, Ghobadi R, Ghobadi F. Solitary bilateral palmar masses as initial presentation of sarcoidosis. Am J Orthop. 2003;32:144–6.

    PubMed  Google Scholar 

  7. Kelly JL, O'Shaughnessy M, O'Connor TP. The radiological appearance of recurrent phalangeal sarcoidosis. Hand Surg. 2002;7:187–9. doi:10.1142/S0218810402001187.

    Article  PubMed  Google Scholar 

  8. Kerdel FA, Moschella SL. Sarcoidosis. An updated review. J Am Acad Dermatol. 1984;11:1–19. doi:10.1016/S0190-9622(84)70133-2.

    Article  CAS  PubMed  Google Scholar 

  9. Kwon B, Bindra RR, Liakos P, et al. Extensive nodular sarcoidosis in the hand. J Hand Surg [Br]. 1997;22:676–8. doi:10.1016/S0266-7681(97)80375-0.

    CAS  Google Scholar 

  10. Landi A, Brooks D, De Santis G. Sarcoidosis of the hand—report of two cases. J Hand Surg [Am]. 1983;8(2):197–200.

    CAS  Google Scholar 

  11. Mangas C, Fernández-Figueras MT, Fité E, et al. Clinical spectrum and histological analysis of 32 cases of specific cutaneous sarcoidosis. J Cutan Pathol. 2006;33:772–7. doi:10.1111/j.1600-0560.2006.00563.x.

    Article  PubMed  Google Scholar 

  12. Morgan SS, Aslam MB, Mukkanna KS, et al. A rare presentation of sarcoidosis, back pain and spondylolisthesis. J Bone Joint Surg Br. 2008;90:240–2. doi:10.1302/0301-620X.90B2.19917.

    Article  CAS  PubMed  Google Scholar 

  13. Newman LS, Rose CS, Maier LA. Review article. Sarcoidosis. N Engl J Med. 1997;336:1224–34. doi:10.1056/NEJM199704243361706.

    Article  CAS  PubMed  Google Scholar 

  14. Niemer GW, Bolster MB, Buxbaum L, et al. Carpal tunnel syndrome in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2001;18:296–300.

    CAS  PubMed  Google Scholar 

  15. Pierson DJ, Willett ES. Sarcoidosis presenting with finger pain. JAMA. 1978;239:2023–4. doi:10.1001/jama.239.19.2023.

    Article  CAS  PubMed  Google Scholar 

  16. Poznanski AK. The hand in radiological diagnosis: with gamuts and pattern profiles. Vol. 2. 2nd ed. Philadelphia: Saunders; 1984. p. 873–5.

    Google Scholar 

  17. Resnick D. Sarcoidosis. In: Resnick D, editor. Diagnosis of bone and joint disorders. 5th ed. Philadelphia: Saunders; 2002. p. 4774–8.

    Google Scholar 

  18. Rizzato G. Extrapulmonary presentation of sarcoidosis. Curr Opin Pulm Med. 2001;7:295–7. doi:10.1097/00063198-200109000-00008.

    Article  CAS  PubMed  Google Scholar 

  19. Shimoni A, Hershcovici T, Mekhmandarov S, et al. Skeletal sarcoidosis: successful treatment with hydroxychloroquine. Isr Med Assoc J. 2000;2:558–9.

    CAS  PubMed  Google Scholar 

  20. Terzioglu A, Bingul F, Tuncali D, et al. Osseous destruction and rupture of the extensor tendon caused by sarcoidosis of the finger. Scand J Plast Reconstr Surg Hand Surg. 2004;38:317–9. doi:10.1080/02844310410027248.

    Article  PubMed  Google Scholar 

  21. Ugwonali OF, Parisien M, Nickerson KG, et al. Osseous sarcoidosis of the hand: pathologic analysis and review of the literature. J Hand Surg [Am]. 2005;30:854–8.

    Article  Google Scholar 

  22. Van Linthoudt D, Ott H. An unusual case of sarcoid dactylitis. Br J Rheumatol. 1986;25:222–4. doi:10.1093/rheumatology/25.2.222.

    Article  PubMed  Google Scholar 

  23. Waanders F, van Hengel P, Krikke A, et al. Sarcoidosis mimicking metastatic disease: a case report and review of the literature. Neth J Med. 2006;64:342–5.

    CAS  PubMed  Google Scholar 

  24. Wilcox A, Bharadwaj P, Sharma OP. Bone sarcoidosis. Curr Opin Rheumatol. 2000;12:321–30. doi:10.1097/00002281-200007000-00016.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank the Borders General Hospital Radiology Department, in particular Luis Ferrando, for invaluable assistance with the radiological images seen within this manuscript.

Sources of financial support

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andrew D. Duckworth.

About this article

Cite this article

Duckworth, A.D., Hill, A.T., Beggs, I. et al. Sarcoidosis Presenting as a Proximal Phalangeal Bony Swelling—a Case and Review of the Literature. HAND 5, 90–94 (2010). https://doi.org/10.1007/s11552-009-9207-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11552-009-9207-6

Keywords

Navigation