Long-term radiographic follow-up in a patient with osteosclerotic sarcoidosis of the spine and pelvis

Abstract

Eight-year clinical and radiographic data in a patient with sarcoidosis manifesting as pelvic and spinal osteosclerosis and as mediastinal lymphadenopathy are described, extending the initial report of this case written after three years of follow-up. The osteosclerotic lesions involved the right iliac and sacral wings, as well as two lumbar vertebras, which had an ivory appearance. There was also evidence of right sacroiliitis, pubic symphysitis and T7-T8 discitis. The diagnosis was established by bone and mediastinal lymph node biopsies. Follow-up was eight years at the time of this writing. The osteosclerotic lesions improved, disappearing almost completely at the lumbar spine, and fusion occurred at the right sacroiliac joint, pubic symphysis, and T7-T8 intervertebral disk. A review of the literature found 13 similar cases, with noticeably shorter follow-ups. The characteristics of axial osteosclerotic sarcoidosis are reviewed, and the indications of corticosteroid therapy are discussed.