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Objective: Sarcoidosis is a chronic inflammatory disease that affects many organs and systems, especially the lungs, lymph nodes and musculoskeletal system. Musculoskeletal system involvement patterns in sarcoidosis are not well defined and literature data are limited in terms of clinical features. This study aimed to investigate the clinical and demographic characteristics of sarcoidosis patients with musculoskeletal system involvement. Methods: One hundred and four patients with sarcoidosis who were followed up in our clinic between June 2020 and January 2024 were evaluated retrospectively. Forty-four sarcoidosis patients aged >18 years with objectively detected musculoskeletal system involvement were included in the study. The musculoskeletal system involvement patterns, clinical and laboratory findings, and demographic characteristics of the patients were analyzed. Results: Musculoskeletal involvement was found in 44 of the 104 sarcoidosis patients (42%). Of the 44 patients with musculoskeletal involvement, 37 (77.3%) were female, the mean age was 46.9±12.2 years, and the mean follow-up time was 14±11.8 months. The most common objective musculoskeletal pathology was chronic arthritis (17%), mostly in the form of chronic oligoarthritis. Wrist (50% vs. 3.8%, p=0.001) and metacarpophalangeal joint involvement (38.9% vs. 0, p=0.001) were significantly higher in patients with chronic arthritis than in patients with acute arthritis. While joint involvement starting as monoarthritis was an independent negative predictor for the development of chronic arthritis [odds ratio (OR): 0.046, 95% confidence interval (CI): 0.003-0.815, p=0.036], the presence of obesity at baseline was a positive predictor for the development of chronic arthritis (OR: 11.968, 95% CI: 1.069-133.960, p=0.044). Conclusion: Sarcoidosis can present with a wide range of musculoskeletal manifestations. The most common musculoskeletal pathologies in sarcoidosis are acute and chronic arthritis. Sarcoidosis patients presenting with monoarthritis do not usually develop chronic arthritis. Patients with chronic sarcoid arthritis initially present more hand-joint involvement. Obesity is a risk factor for the development of chronic arthritis.

INTRODUCTION: Fibromyalgia (FM) is the most common cause of chronic generalized musculoskeletal pain. The etiology and the pathophysiology are still not clear but there are some studies that elucidate relationship between FM and thyroid diseases. The aim of this study was to determine the frequency of FM in patients with hypothyroidism. METHODS: This is a cross-sectional, single-center, and prospective study from Bakırkoy Dr Sadi Konuk Training and Research Hospital. A total of 180 patients – who were applied to internal medicine outpatient clinics – included in the study and the patients who described the generalized musculoskeletal pain were consulted to the physical medicine and rehabilitation outpatient clinics. Demographic data, laboratory findings, presence of thyroid disease, and FM were noted. Patients were evaluated with Beck Depression Questionnaire (BDQ) and FM Impact Questionnaire (FIQ) for FM patients. RESULTS: About 39.4% (n=71) of the patients had FM and 60.6% (n=109) of them did not have FM. There was a positive correlation between FIQ score and age at diagnosis and disease duration. As the age at diagnosis and duration of disease increased, the FIQ score increased by 37.3% and 25.7%, respectively. In addition, as BDQ increased, the FIQ score increased by 44.8%. DISCUSSION AND CONCLUSION: Signs and symptoms of hypothyroidism are similar to signs and symptoms of FM, and approximately 40% of patients with hypothyroidism could have FM concomitantly. Hence, the presence of a diagnosis of hypothyroidism should not cause us to miss the diagnosis of FM in these patients. Therefore, all patients with hypothyroidism should also be examined for FM.