Multisystemic sarcoidosis with uncommon osseous involvement demonstrated by Ga-67 citrate and Tc-99m MDP

Sarcoid bone lesions are uncommon, and involvement is more frequent in the small bones of the hands and feet than in the long bones, vertebrae, or skull. Involvement of the calcaneus is exceedingly rare. The authors report a case of sarcoidosis with calcaneus involvement in addition to long-bone and disseminated multisystem involvement. Ga-67 scanning demonstrated multiple sites of increased uptake in the left ventricle, bony structures, joints, lymph nodes, subcutaneous tissue of the extremities, salivary glands, and lacrimal glands. Low-dose oral glucocorticoid therapy provided clinical and scintigraphic improvement.