Bone scintigraphy in osseous sarcoidosis

Sarcoidosis is a systemic, granulomatous disorder that affects multiple organ systems, but most often the lungs and the skin. The incidence of radiographically evident osseous involvement is between 1% and 13%, with an average of 5% on conventional imaging. Sarcoidosis generally involves the peripheral skeleton with the phalanges, metacarpals, and metatarsals being most frequently affected. The majority of osseous lesions occur in the phalanges of the hands. Involvement of the axial skeleton is rather uncommon. Sarcoid bone lesions are usually asymptomatic. Nuclear medicine studies, in particular bone scintigraphy, gallium-67 (Ga-67) and F-18 fluoro-2-deoxyglucose positron emission tomography (F-18 FDG PET) have been used in staging of sarcoidosis, including assessment of extrapulmonary involvement. Here, we present a case of osseous sarcoidosis in a man whom the disease presented with multiple lesions in the axial skeleton and the long bones.