Periarticular inflammation, bilateral hilar adenopathy and a sarcoid reaction

A total of 19 cases of bilateral hilar adenopathy in association with polyarthritis are presented. Erythema nodosum, usually occurring in this syndrome, was not present; however, marked periarticular inflammation of the ankles with little pain on motion was noted and served as the initial clue to the diagnosis. All patients had elevated sedimentation rates; hyperglobulinemia and positive tests for rheumatoid factor were frequently found. A sarcoid reaction was seen in 73% of the patients whose tissue was examined histologically. Diagnosis was established by the radiologic demonstration of bilateral hilar adenopathy. Prognosis was favorable. The etiology of the disorder is unknown, and its relationship to Boeck's sarcoidosis Is uncertaian.