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Imaging in sarcoid disease.

Best Pract Res Clin Rheumatol

March 2025

Department of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55902, USA. Electronic address:

Sarcoidosis is a complex multisystem inflammatory disease characterized by noncaseating granulomas and variable clinical manifestations, most commonly affecting the lungs, skin, heart, and nervous system. Imaging is central in its diagnosis, staging, and management, providing essential insights into organ involvement and disease activity. Pulmonary manifestations remain the hallmark, with modalities such as high-resolution chest computed tomography (CT) and chest radiography offering critical diagnostic clues.

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Chronic aortic dissection is a complex disease with a heterogenous clinical course. Specialised imaging is necessary for the long-term surveillance of this disease to identify patients who meet the criteria for intervention, and to monitor surgically treated patients for complications. Whilst computed tomography and magnetic resonance imaging are the most widely utilised modalities, providing a high degree of anatomical detail and reproducible aortic measurements, they are not without significant limitations.

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A boy in middle childhood with a history of early morning headaches presented to secondary care after being found to have bilateral papilloedema by his community optometrist. CT head showed a large right-sided heterogeneous calcific and haemorrhagic mass causing marked mass effect and midline shift. Preoperatively, the lesion was characterised on MRI as a haemorrhagic mass with a 'popcorn' appearance suggestive of a giant cavernous malformation measuring 6.

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Intraorbital foreign bodies (IOFBs) are a recognised complication of orbital trauma, but intraorbital wooden foreign bodies are rare and pose significant diagnostic and management challenges due to their radiolucency, high risk of infection and potential for severe inflammation. This case describes a rare presentation of a young boy who sustained orbital trauma after an 8-foot fall, resulting in a 5 cm × 3 cm wooden IOFB extending to the orbital apex with an associated sphenoid fracture. He presented with proptosis, an inferotemporal scleral indentation mimicking retinal detachment and a lateral infraorbital laceration.

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Early manifestations of large-vessel vasculitis are often non-specific, which can result in missed or delayed diagnosis. A case of Takayasu arteritis with femoral artery predominance diagnosed using fluorodeoxyglucose-positron emission tomography/CT (FDG-PET/CT) imaging in a patient with fevers, myalgia, lower limb claudication and erectile pain is presented in this report. This case report describes an unusual genitourinary manifestation of vasculitis and highlights the utility of FDG-PET/CT in the diagnostic work-up of patients with fever of unknown origin.

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