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Rapid development of sarcoid tenosynovitis
Lara Lambert1, Ellen C Riemer, Marc A Judson
1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA.
Summary
Sarcoidosis can cause acute tenosynovitis, presenting as painless nodules on hand and wrist tendons. This condition, often affecting the upper extremities, may resolve with medication or surgery.
Area of Science:
- Rheumatology
- Immunology
- Orthopedic Surgery
Background:
- Sarcoidosis is a multisystem inflammatory disease characterized by non-caseating granulomas.
- Tenosynovitis, inflammation of the tendon sheath, is a rare manifestation of sarcoidosis.
- This condition predominantly affects the upper extremities, involving both flexor and extensor tendons.
Observation:
- A case of acute tenosynovitis in a patient with known pulmonary sarcoidosis is presented.
- The patient developed rapidly progressing, painless nodules on the dorsal tendon sheaths of both hands and wrists.
- This presentation highlights a less common but significant musculoskeletal manifestation of sarcoidosis.
Findings:
- Sarcoid tenosynovitis typically occurs in the upper extremities, affecting tendons symmetrically.
- Treatment options include corticosteroids, immunomodulating agents like methotrexate, surgical debulking, and tendon sheathectomy.
- Spontaneous resolution of sarcoid tenosynovitis has also been documented.
Implications:
- Early recognition and diagnosis of sarcoid tenosynovitis are crucial for appropriate management.
- Understanding the varied presentations of sarcoidosis aids in comprehensive patient care.
- This case contributes to the literature on sarcoidosis-related musculoskeletal complications and their treatment outcomes.
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