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Early arthritis
Usually begins in one or both ankles and can additively involve knees, wrists, and hands
Strongly associated with erythema nodosum and often produces more periarticular swelling than frank joint swelling
Axial skeleton spared
Commonly self-limited, resolving after several weeks or months and rarely resulting in chronic arthritis, joint destruction, or significant deformity
Late arthritis is less severe and less widespread
Dactylitis (sausage digit) may occur in association with overlying cutaneous sarcoidosis
Often associated with erythema nodosum
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Contingent on demonstration of other extra-articular manifestations of sarcoidosis and biopsy evidence of noncaseating granulomas
In chronic arthritis, radiographs show typical changes in the bones of the extremities with intact cortex and cystic changes
Despite the clinical appearance of an inflammatory arthritis, synovial fluid often is noninflammatory (ie, < 2000 leukocytes/mcL [2.0 × 109/L])
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Usually symptomatic and supportive
Corticosteroids or TNF inhibitors may be effective in patients with severe and progressive joint disease
Colchicine may be of value