Symptomatic nodular myopathy: an atypical presentation of sarcoidosis

Symptomatic myopathy is a very rare extrapulmonary manifestation of sarcoidosis that may not be readily recognised in the absence of a known history of sarcoid. Nodular myopathy is the most uncommon subtype of musclar sarcoidosis and, when encountered, establishing the diagnosis can be challenging. We present a case of symptomatic nodular myopathy as a first presentation of sarcoidosis in a young man who required a multidisciplinary approach to diagnose. The patient presented to our radiology department following a short period of flu-like illness and multiple soft tissue lesions. Biopsy of the lesions demonstrated noncaseating granulomata, and a diagnosis of sarcoidosis was established after important differential diagnoses were excluded. We present a literature review of sarcoid-related myopathy and the multimodality imaging characteristics of the different subtypes.