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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 2, 240-242.
doi: 10.1302/0301-620X.90B2.19917  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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A rare presentation of sarcoidosis, back pain and spondylolisthesis

S. S. Morgan, MBBCh, MRCS, Specialist Registrar in Orthopaedics (LAT)1; M. B. Aslam, MBBS, MRCPath, Consultant Pathologist2; K. S. Mukkanna, MBBS, MD, DNB, Trust Registrar3; and G. Ampat, FRCS(Trauma & Orth), Consultant Orthopaedic Surgeon1

1 Southport Hospital, Town Lane Kew, Southport PR8 6PN, UK.
2 Histopathology Department Royal Blackburn Hospital, Haslingdon Road, Blackburn BB2 3HH, UK.
3 Dermatology Ormskirk District General Hospital, Wigan Road, Ormskirk L39 2AZ, UK.

Correspondence should be sent to Mr S. S. Morgan; e-mail: samermorgan{at}yahoo.com

A 48-year old man presented with back pain that was resistant to treatment. An MR scan showed spondylolisthesis at L4-5 and narrowing of the exit foraminae. He had a posterior fusion which did not relieve his symptoms. He continued to have back pain and developed subcutaneous nodules in both forearms. Biopsy from the skin revealed cutaneous sarcoidosis, and one from the lumbar spine showed sarcoidosis granuloma between the bone trabeculae. A CT scan of the abdomen and chest revealed axillary lymphadenopathy, mediastinal enlarged nodes, apical nodular nodes and splenomegaly. The patient was started on large doses of methotrexate and steroids. His angiotensin-converting enzyme and calcium levels returned to normal and the back pain resolved.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General