Management of a patient with sarcoid calcaneitis and dactylitis
Identifieur interne : 000372 ( Istex/Curation ); précédent : 000371; suivant : 000373Management of a patient with sarcoid calcaneitis and dactylitis
Auteurs : Yannick Allanore [France] ; Serge Perrot [France] ; Charles-Joël Menkès [France] ; André Kahan [France]Source :
- Joint Bone Spine [ 1297-319X ] ; 2001.
English descriptors
- KwdEn :
- Teeft :
- Bolus, Bone lesions, Calcaneal, Calcaneitis, Calcaneus, Case report, Chronic forms, Consecutive days, Dactylitis, Dramatic improvement, Further recurrences, Glucocorticoid, Glucocorticoid therapy, Hand surg, Hydroxychloroquine, Joint bone spine, Joint destruction, Lesion, Magnetic resonance imaging, Methotrexate, Middle finger, Nger, Radiograph, Recurrence, Sarcoid, Sarcoid bone lesions, Sarcoid calcaneitis, Sarcoidosis, Second phalanx.
Abstract
Abstract: Dactylitis and calcaneitis developed in a patient with untreated sarcoidosis of the skin and lungs. Radiographs showed a defect in the second phalanx of the left middle finger. Radiographs of the feet were normal, but magnetic resonance imaging demonstrated a defect in the left calcaneus. Methylprednisolone therapy (1 g per day for 3 consecutive days) induced a dramatic improvement within 48 hours. Low-dose oral glucocorticoid therapy was given subsequently. One year later, a recurrent episode of dactylitis responded promptly to the same regimen. Maintenance therapy was given, and no further recurrences were noted during the four-year follow-up. Sarcoid bone lesions are uncommon and arise selectively in the small bones of the hands and feet. Involvement of the calcaneus is exceedingly rare, and its treatment is not standardized. In our patient, glucocorticoid therapy combined with methotrexate and hydroxychloroquine were effective in controlling the disease.
Url:
DOI: 10.1016/S1297-319X(01)00251-2
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<term>Case report</term>
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<front><div type="abstract" xml:lang="en">Abstract: Dactylitis and calcaneitis developed in a patient with untreated sarcoidosis of the skin and lungs. Radiographs showed a defect in the second phalanx of the left middle finger. Radiographs of the feet were normal, but magnetic resonance imaging demonstrated a defect in the left calcaneus. Methylprednisolone therapy (1 g per day for 3 consecutive days) induced a dramatic improvement within 48 hours. Low-dose oral glucocorticoid therapy was given subsequently. One year later, a recurrent episode of dactylitis responded promptly to the same regimen. Maintenance therapy was given, and no further recurrences were noted during the four-year follow-up. Sarcoid bone lesions are uncommon and arise selectively in the small bones of the hands and feet. Involvement of the calcaneus is exceedingly rare, and its treatment is not standardized. In our patient, glucocorticoid therapy combined with methotrexate and hydroxychloroquine were effective in controlling the disease.</div>
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