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Case of the Week 327 
What's the most likely diagnosis?
- 43 year-old woman presents with pain and swelling
- Psoriasis
- Metastatic disease
- Sarcoid
- Hyperparathyroidism
- Reiter's syndrome
Additional Images - Frontal view of both hands
Answer:
3. Sarcoid
More (Click Discussion Tab)
Sarcoid of the feet and hands
General Considerations
- Radiographic evidence of osseous involvement occurs in about 5% of patients with sarcoidosis
- Arthralgia in patients with sarcoid may occur in up to 1/3 of patients
- Patients are usually between 20-40, more frequently women
- Typically affects multiple joints
- Most often affects hands, feet and ankles (the latter in acute form)
- Lesions in long bones, skull or spine are rare
- Often occurs in association with pre-existing pulmonary and/or skin lesions such as lupus pernio
- Purplish, indurated macules or papules on the face considered classic for sarcoid
- May occasionally be presenting manifestation of sarcoid
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LearningRadiology.com is an award-winning educational site aimed primarily at medical students and radiology residents-in-training, containing lectures, handouts, images, Cases of the Week, archives of case quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, cardiac, and bone radiology.
