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For further information, see CMDT Part 20-42: Arthritis in Sarcoidosis

Key Features

  • May occur early (within 6 months of onset of symptoms) or late

  • Occurs in 10–35% of patients with sarcoidosis

  • Often associated with erythema nodosum

  • Rarely deforming

Clinical Findings

  • Usually acute in onset, but may appear insidiously and antedate other manifestations of sarcoidosis

  • Knees and ankles are most commonly involved, but any joint can be affected

  • Distribution of joint involvement is usually polyarticular and symmetric

  • Often associated with erythema nodosum

  • Commonly self-limited, resolving after several weeks or months and rarely resulting in chronic arthritis, joint destruction, or significant deformity


  • 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])


  • Usually symptomatic and supportive

  • Corticosteroids, methotrexate, or TNF inhibitors may be effective in patients with severe and progressive joint disease

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