Acute sarcoid myositis with unusual radiologic findings

A 59-year-old man presented with bilateral calf pain and swelling for two weeks. Ultrasound and magnetic resonance imaging examination showed multiple bilateral, nodular, and spindle- shaped lesions in the gastrocnemius and soleus muscles. On physical examination, hyperpigmented, papular lesions were noticed; biopsy of the skin of his right elbow showed granulomatous inflammation. His angiotensin converting enzyme level was markedly elevated. Computed tomography showed diffuse interstitial thickening, miliary nodules, and traction bronchiectases throughout the lung parenchyma. Ophthalmologic examination showed uveitis in his left eye. Based on the lung, eye, and skin findings, a clinical diagnosis of sarcoidosis was made. After two months of corticosteroid treatment, his muscle lesions largely resolved.