Fig. 4.
Examples of musculoskeletal involvement in sarcoidosis. (A) Punched-out cortical lesions and coarsened trabeculae yield a characteristic lacelike pattern in the proximal, middle, and distal phalanges. (B) Focal targetlike lesions in the vertebral bodies seen on sagittal short-tau inversion recovery sequence MRI. (C) Multiple large, lytic lesions within the skull of a patient with sarcoidosis. (D) Lobular lesions (arrow) within the vastus medialis muscle on gadolinium-enhanced MRI. (Courtesy of [A, C, D] Dr S. Smith, Brigham and Women’s Hospital, Boston, MA; and [B] Dr K. Talekar, Thomas Jefferson University Hospital, Philadelphia, PA.)