Prevalence, distribution and clinical significance of joints, muscles and bones in sarcoidosis: an 18F-FDG-PET/CT study.,Expert Review of Respiratory Medicine

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Prevalence, distribution and clinical significance of joints, muscles and bones in sarcoidosis: an 18F-FDG-PET/CT study.
Expert Review of Respiratory Medicine ( IF 3.9 ) Pub Date : 2020-06-17 , DOI: 10.1080/17476348.2020.1775587
Spyros A Papiris ₁ , Effrosyni D Manali ₁ , Andriana I Papaioannou ₁ , Alexandros Georgakopoulos _{2,

3} , Lykourgos Kolilekas ₄ , Nikoletta K Pianou _{3,

5} , Maria Kallergi _{3,

6} , Anastasia Papaporfyriou ₁ , Maria Kallieri ₁ , Vasiliki Apollonatou ₁ , Georgia Papadaki ₁ , Katerina Malagari ₇ , Nikolaos L Kelekis ₇ , Spyros G Pneumatikos ₈ , Sofia Chatziioannou _{2,

3}

Affiliation

ABSTRACT

Objectives

In Sarcoidosis joints-muscles-bones (JMBs) localizations are of the least common. ¹⁸F-FDG-PET/CT imaging revolutionized detection of JMBs involvement by adding metabolic activity information and allowing for a comprehensive, whole-body mapping of the disease.

Aim and methods

This study investigated prevalence, distribution, and clinical significance of JMBs sarcoidosis in 195 consecutive patients that underwent ¹⁸F-FDG PET/CT examination.

Results

Joint and bone involvement were encountered in 15% of patients with a mean of the maximum-standardized-uptake-value (SUV_max) of 6.1. Most common location was the axial skeleton. Hypercalciuria was significantly more frequent in patients with osseous involvement (p = 0.003). Muscle activity (SUVmax = 2.4) was encountered in 20% of the patients, most frequently in treatment-naïve (p = 0.02). The muscles of the lower extremities were affected the most. Muscle and bone localization coexist in 50% of the cases. JMBs disease was almost asymptomatic, not related to chronicity but to pulmonary, nodal, and systemic disease. Long-term follow-up and treatment response of affected patients confirmed sarcoidosis.

Conclusion

¹⁸F-FDG-PET/CT revealed JMBs localizations and coexistence with other organ sites supporting the concept that sarcoidosis is a systemic disease. By allowing an integrative interpretation of multi-organ involvement in the context of a pattern highly suggestive of sarcoidosis, it strongly keeps-off the diagnosis of malignancy.

中文翻译：

结节病中关节，肌肉和骨骼的患病率，分布及其临床意义：一项18F-FDG-PET / CT研究。

摘要

目标

在结节病中，关节，肌肉，骨骼（JMBs）的定位最不常见。¹⁸ F-FDG-PET / CT成像通过添加代谢活性信息并允许对该疾病进行全面的全身成像，彻底改变了JMB的检测。

目的与方法

这项研究调查了连续¹⁸例接受F-FDG PET / CT检查的195例患者中JMB结节病的患病率，分布及其临床意义。

结果

15％的患者遇到关节和骨骼受累，最大标准化摄取值（SUV _max）平均值为6.1。最常见的位置是轴向骨架。骨累及患者高钙尿症的发生率明显更高（p = 0.003）。在20％的患者中出现肌肉活动（SUVmax = 2.4），在未接受治疗的患者中最为频繁（p = 0.02）。下肢的肌肉受影响最大。肌肉和骨骼定位共存50％。JMBs疾病几乎无症状，与慢性无关，但与肺部，淋巴结和全身性疾病有关。受影响患者的长期随访和治疗反应证实了结节病。