An unusual presentation of muscular sarcoidosis

Sarcoidosis is a noncaseating granulomatous disease that involves multiple organs, most commonly the lungs, lymph nodes, skin, and eyes, but may be clinically evident in any organ system. Symptomatic muscular sarcoidosis is very rare and has been reported in only 1.4% of known sarcoidosis cases, while skeletal involvement has been reported in 1-13%. Different types of muscular and osseous sarcoidosis have been described in the literature. We present a case of muscular sarcoidosis, which is unique in its clinical presentation and imaging findings. The presence of the marked periosteal reaction, which has never been described with muscular sarcoidosis, also makes this case unique.