# Challenging diagnosis: unveiling extensive multisystemic sarcoidosis with musculoskeletal involvement through a clinically ambiguous soft tissue mass in the palm

## TL;DR

A man's hand mass led to the discovery of widespread sarcoidosis, showing how challenging it can be to diagnose this condition early.

## Contribution

Highlights musculoskeletal imaging findings as key indicators for diagnosing sarcoidosis in ambiguous cases.

## Key findings

- A soft tissue mass in the palm was the first sign of multisystemic sarcoidosis.
- Sarcoidosis can present with musculoskeletal involvement, mimicking benign conditions.
- Early recognition of imaging findings can improve patient management.

## Abstract

We report about a 33-year-old man who was referred for assessment of a progressively enlarging mass of the palmar hand muscles, serving as the initial indication of extensive multisystemic sarcoidosis with musculoskeletal involvement. The case underscores the diagnostic challenges associated with the indolent course of sarcoidosis, highlighting the need for recognizing seemingly benign symptoms for early detection. Musculoskeletal imaging findings presented in the case stress the importance of considering sarcoidosis in the differential diagnosis of orthopedic cases. This report emphasizes the importance of understanding possible musculoskeletal imaging findings in sarcoidosis, thereby enabling radiologists to effectively guide patient management.