Rheumatology, The University of Vermont Medical Center, Burlington, VT, USA.
Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Int J Rheum Dis. 2021 Apr;24(4):533-541. doi: 10.1111/1756-185X.14068. Epub 2021 Feb 9.
Musculoskeletal (MSK) sarcoidosis presents with a variety of clinical phenotypes. Four subtypes of MSK sarcoidosis have been identified to date: Lofgren syndrome, chronic sarcoid arthritis, osseous sarcoidosis, sarcoid myopathy. Each subtype has been reported with varying incidence mainly due to lack of universal classification criteria.
We performed a retrospective chart review of patients with MSK sarcoidosis at a single academic center between January 2000 and December 2014. Descriptive statistics were used to describe the proportion of patients with sarcoidosis who had the 4 MSK syndromes of interest, demographic characteristics and therapeutic agents used.
A cohort of 58 patients with MSK manifestations were identified among 1016 patients with sarcoidosis. Frequency of subtypes include: Lofgren syndrome 46.6%, osseous sarcoidosis 25.9%, chronic sarcoid arthritis 24.1% and sarcoid myopathy 6.9%. The cohort was predominantly female (43/58 patients, 74%) and Caucasian (48/58 patients, 82.8%). Mean age was 47.2 years. One patient had overlap of osseous sarcoidosis and chronic sarcoid arthritis, another patient initially had Lofgren syndrome and later developed chronic sarcoid arthritis. Sarcoid myopathy patients presented with myalgia more often than muscle weakness.
We identified a large cohort of MSK sarcoidosis and determined the prevalence of all 4 subtypes. In patients who do develop MSK manifestations of sarcoidosis, they are commonly a part of the initial presentation of sarcoidosis. There is an unmet need to establish standardized classification criteria for the 4 MSK sarcoidosis syndromes.
肌肉骨骼（MSK）结节病表现出多种临床表型。迄今为止，已经确定了四种 MSK 结节病亚型：洛弗根综合征、慢性结节病性关节炎、骨结节病、结节病性肌病。由于缺乏通用的分类标准，每种亚型的发病率都有所不同。
我们对 2000 年 1 月至 2014 年 12 月期间在一家学术中心就诊的 MSK 结节病患者进行了回顾性图表审查。使用描述性统计数据来描述患有 4 种 MSK 综合征的结节病患者的比例、人口统计学特征和使用的治疗药物。
在 1016 例结节病患者中发现了 58 例 MSK 表现的患者。亚型的频率包括：洛弗根综合征 46.6%、骨结节病 25.9%、慢性结节病性关节炎 24.1%和结节病性肌病 6.9%。该队列主要为女性（43/58 例，74%）和白种人（48/58 例，82.8%）。平均年龄为 47.2 岁。一名患者同时患有骨结节病和慢性结节病性关节炎，另一名患者最初患有洛弗根综合征，后来发展为慢性结节病性关节炎。结节病性肌病患者更常出现肌痛而非肌无力。
我们确定了一个较大的 MSK 结节病队列，并确定了所有 4 种亚型的患病率。在确实出现结节病的 MSK 表现的患者中，它们通常是结节病初始表现的一部分。目前迫切需要为 4 种 MSK 结节病综合征建立标准化的分类标准。
