How does skeletal muscle sarcoidosis present clinically

How does skeletal muscle sarcoidosis present clinically?

Sarcoid myopathy typically occurs in patients with multiorgan involvement. Although muscle involvement in sarcoidosis is usually asymptomatic, there are three clinical presentations: nodular, acute myositic, and chronic myopathic. The nodular presentation is the least common type, involving the musculotendinous junctions and demonstrating a “dark star” pattern on muscle magnetic resonance imaging (MRI). Acute granulomatous inflammatory myositis is rare, occurs mainly in African–American women, and is indistinguishable clinically from polymyositis. Chronic myopathy is the most common form and is manifested by an insidious onset of proximal symmetric muscle weakness and wasting. Neurogenic atrophy due to granulomatous infiltration of nerves can occur. Muscle enzyme levels, electromyography, and muscle biopsies are necessary to differentiate the different types of muscle involvement. The acute myositis will respond to corticosteroids, whereas the nodular and chronic myopathic forms are less likely to respond.

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