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Bony Sarcoidosis

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Imaging findings

While a thoracic spine CT demonstrates no visible sclerotic or lytic abnormalities, cardiac MRI sequences capture the thoracic spine and reveal focal, abnormal areas of marrow enhancement involving the posterior elements and pedicles of adjacent vertebral levels. Sagittal MR imaging further characterizes these adjacent focal lesions, which mimic metastatic disease.

Key takeaways

Skeletal involvement in sarcoidosis is relatively rare, typically affecting the small bones of the hands and feet, but can also involve the axial skeleton. Bony sarcoidosis may be completely occult on CT scans while showing extensive marrow infiltration and contrast enhancement on MRI, which can closely mimic metastatic disease (such as prostate cancer metastases).

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