Sarcoidosis Presenting With Finger Pain

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Abstract
THE CLINICAL onset of sarcoidosis is notoriously varied, with initial symptoms in any of several organ systems. Involvement of the skeleton is usually asymptomatic, however, and typically occurs in the course of established, generalized disease. We report the case of a patient with pain from an apparently isolated lytic bone lesion constituting the only presenting symptom. Report of a Case A 21-year-old man complained of pain and swelling of one month's duration at the tip of his right index finger. There was no history of trauma to the finger. Minimal swelling, redness, and palpation tenderness of the distal phalanx of the right index finger were the only physical findings. Roentgenographic examination of the hands demonstrated a 4-mm lytic lesion in the right index finger at the tip of the distal phalanx, with resorption of the terminal tuft (Fig 1). A chest roentgenogram showed prominent bilateral hilar adenopathy (Fig 2). Routine

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