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Synovial cysts and sarcoid synovitis.

A H Isdale1, J M Iveson

  • 1Rheumatology and Rehabilitation Unit, Leeds.

British Journal of Rheumatology
|July 1, 1992
PubMed
Summary

A rare case of sarcoidosis presented as painless cysts and leg swelling. Biopsies confirmed sarcoidosis, highlighting the diagnostic importance of tissue sampling for this uncommon joint disease presentation.

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Area of Science:

  • Rheumatology
  • Dermatology
  • Pathology

Background:

  • Sarcoidosis is a multisystem inflammatory disease of unknown etiology.
  • Joint involvement in sarcoidosis can manifest in various ways, including arthritis and tenosynovitis.
  • Synovial cysts are an exceptionally rare manifestation of sarcoid joint disease.

Observation:

  • A practice nurse presented with painless cystic swellings in the popliteal and antecubital fossae.
  • The patient also exhibited lymphoedema of the legs.
  • Initial diagnosis was not apparent prior to tissue sampling.

Findings:

  • Biopsies of synovium, a breast lump, axillary lymph nodes, and the Kveim site were performed.
  • Histopathological examination of all biopsied sites demonstrated granulomatous inflammation consistent with sarcoidosis.
  • The findings confirmed sarcoidosis as the underlying cause of the patient's symptoms.

Implications:

  • This case underscores the diagnostic challenge posed by rare presentations of sarcoidosis.
  • Synovial cysts should be considered in the differential diagnosis of cystic masses, particularly in patients with suspected or known sarcoidosis.
  • Biopsy remains a crucial diagnostic tool for establishing the definitive diagnosis of sarcoidosis, especially in atypical cases.

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