Diagnostic Difficulties in Bone Sarcoidosis Imaging. A Cases Study.

Sarcoidosis is a multiorgan inflammatory disease that rarely involves the musculoskeletal system. A typical radiographic presentation is only noted with phalangeal lesions in the hands and feet, and other skeletal sites of sarcoidosis are a diagnostic imaging challenge [1]. We describe two cases of patients with sarcoidosis in whom pathologic bone marrow lesions were diagnosed on MRI scans. The magnetic resonance findings were non-specific and metastatic lesions or multiple myeloma were suspected. The case analysis serves to point to limitations of imaging studies in diagnosing bone sarcoidosis and underline the importance of cooperation between the radiologist and the clinician. The role of magnetic resonance imaging in the diagnostic algorithm for bone sarcoidosis should mostly focus on locating lesions, indicating biopsy sites and follow-up of abnormalities.

[Exogenous lipid pneumonia--a report of four cases]. / Egzogenne lipidowe zapalenie pluc--róznorodnosc obrazu klinicznego i radiologicznego.

Exogenous lipoid pneumonia (ELP) is a rare interstitial pulmonary disease caused by aspiration of the oily material. It is known to mimic many pulmonary diseases and causes many diagnostic difficulties. We present four patients with ELP. The clinical picture was very heterogenous. We described these cases to show that the use of the mineral oils may increase the risk of lipoid pnemonia.

[Prognostic value of some clinical, radiological, laboratory and functional parameters in sarcoidosis]. / Wartosc rokownicza wybranych wskazników klinicznych, radiologicznych, biochemicznych i czynnosciowych w przebiegu sarkoidozy u chorych nie leczonych.

Sarcoidosis is a granulomatous disease of unknown origin characterized by the trend to spontaneous remission in the great number of the patients. Some patients require treatment with corticosteroids, which have significant toxicity. The aim of this study was to assess the prognostic role of many different parameters in the patients with sarcoidosis. 162 sarcoidosis patients were introduced to prospective study: 22 patients were treated because of deterioration in lung function or serious ocular disease and 140 were observed without therapy for two years. We assessed the age, sex, symptoms, serum activity of angiotensin converting enzyme (SACE), hypercalcaemia, hypercalciuria, splenomegaly and HRCT findings at the time of diagnosis. We analyzed the frequency of spontaneous remission of sarcoidosis in the untreated patients. We investigated correlation between these parameters and remission. Statistical comparisons were made with chi-square test. We also applied the k nearest neighbor (k-NN) rule and the leave one out method adopted from the statistical pattern recognition theory. From many different parameters only acute symptoms (erythema nodosum, fever, arthritis) and serum activity of ACE might be helpful in predicting prognosis in the patients with stage I of disease. The patient's age at onset less than 36 years, the appearance of erythema nodosum and ground-glass opacities on HRCT scans portend an excellent prognosis in the patients with stage II of disease.