Sarcoidosis in a Clinically Unaffected Joint Demonstrated by Somatostatin Receptor Scintigraphy

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A patient presented with decreased hearing, secondary amenorrhea, vertigo, dry eyes, and progressive loss of vision. Because the differential diagnosis consisted of sarcoidosis and lymphoma, somatostatin receptor scintigraphy with indium-111-DTPA octreotide (In-111 pentetreotide) was performed. Increased uptake was observed in the parotid gland, bilateral orbits, nose, and the right knee. Remarkably, on clinical examination, no signs of arthritis of the right knee were observed. Additional tissue analysis of the right knee revealed the diagnosis of sarcoidosis leading to successful treatment with prednisolone, antimalarials, and azathioprine. This case underlines the diagnostic potential of somatostatin receptor scintigraphy in patients with sarcoidosis, even in clinically unaffected tissue.

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