Thirty-two of 150 Caucasian patients (21%) with sarcoidosis studied had articular symptoms. Twenty-one had acute sarcoid arthritis with bilateral ankle arthritis/periarthritis. Joint symptoms resolved within 4 months and none developed chronic arthropathy or progressive systemic sarcoidosis. Eleven patients developed articular involvement during the course of chronic pulmonary sarcoidosis manifested by bilateral hilar adenopathy in 8 and parenchymal disease in 9. Joint symptoms were generally transient, however, persistent synovitis in excess of one year was seen in 2 patients. Acute sarcoid arthritis confers a favorable prognosis in North American Caucasians. Differences from previous American series likely reflects the racial compositions of the population studied. Sarcoid arthritis less often evolves during the course of chronic systemic sarcoidosis and even then rarely progresses to a chronic arthropathy.