Musculoskeletal and pulmonary outcomes of sarcoidosis after initial presentation of osseous involvement

Sarcoidosis Vasc Diffuse Lung Dis. 2019;36(1):60-73. doi: 10.36141/svdld.v36i1.7326. Epub 2019 Mar 11.


Objective: We aimed to investigate the musculoskeletal and pulmonary outcomes of patients with osseous sarcoidosis.

Methods: We identified 24 patients with osseous sarcoidosis and at least one year of follow-up after diagnosis (baseline). We collected outcome data at 1-year follow-up and last follow-up. We defined a composite outcome measure; worsening considered as worsening in any of the following 4 components compared to baseline: 1) osseous sarcoidosis symptoms, 2) musculoskeletal imaging of affected bone, 3) chest imaging, or 4) pulmonary function testing (PFT).

Results: A minority of patients had a worsening composite outcome at 1-year (9/24, 38%) and last follow-up (5/24, 21%). When only considering musculoskeletal symptoms and imaging, only 25% (6/24) and 13% (3/24) of patients worsened compared to baseline at 1-year and last follow-up, respectively. Patients with a worsening composite overall outcome tended to be older at baseline than those without the outcome for both 1-year (54.3 years vs. 47.5 years, p=0.11) and last follow-up (55.0 years vs. 48.7 years; p=0.23), although these differences were non-significant. Treatment was not associated with worsening composite overall outcome at 1-year follow-up (p=0.40), but was significantly associated with decreased risk for worsening at last follow-up (p=0.05).

Conclusions: In this retrospective cohort study of osseous sarcoidosis, most patients had a favorable outcome according to symptoms, musculoskeletal/chest imaging, and PFTs, even though only a minority were treated with glucocorticoids or DMARDs. These results suggest that the natural history of osseous sarcoidosis is often benign, although some patients experience clinical progression.

Keywords: Autoimmune Disease; Bone Tissue; Health Outcomes; Pulmonary Disease; Pulmonary Function Test; Sarcoidosis.

MeSH terms

  • Adult
  • Age Factors
  • Antirheumatic Agents / therapeutic use
  • Bone Diseases / diagnosis
  • Bone Diseases / drug therapy
  • Bone Diseases / etiology*
  • Disease Progression
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Sarcoidosis / complications*
  • Sarcoidosis / diagnosis
  • Sarcoidosis / drug therapy
  • Sarcoidosis, Pulmonary / diagnosis
  • Sarcoidosis, Pulmonary / drug therapy
  • Sarcoidosis, Pulmonary / etiology*
  • Time Factors
  • Treatment Outcome


  • Antirheumatic Agents
  • Glucocorticoids