The diagnostic value of gastrocnemius muscle biopsy in sarcoidosis presenting with erythema nodosum and hilar adenopathy.

Five cases of sarcoidosis were identified among twenty cases of erythema nodosum, admitted to the Department of Medicine, during a two-year period. The clinical picture was dominated by hilar adenopathy and erythema nodosum in all cases. All five patients had gastrocnemius muscle biopsy performed, which revealed noncaseating epithelioid granuloma in four. Diagnosis in the fifth patient was made by transbronchial lung biopsy. The present study suggests, that gastrocnemius muscle biopsy might be considered as the initial diagnostic procedure of choice in this, more commonly seen in Caucasians, syndrome of sarcoidosis, presenting with hilar adenopathy and erythema nodosum, based on its safety, ease of performance and relatively high sensitivity and specificity.