Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 3 2022 03 16 188 193 Aicha Ben Tekaya Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia . AND Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia Ons Hamdi Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia . ANDFaculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia Leila Rouached Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia. AND Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia Mehdi Bellil Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia . AND Department of Orthopedic, Charles Nicolle Hospital, Tunis, Tunisia Selma Bouden Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia. AND Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia Olfa Saidane Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia. AND Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia Rawdha Tekaya Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia. AND Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia Ines Mahmoud Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia. AND Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia Leila Abdelmoula Department of Rheumatology, Charles Nicolle Hospital, Tunis, Tunisia . AND Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia 2020 10 07 2021 12 09 Bone involvement in sarcoidosis is rare; its estimated prevalence ranges between 3 and 13%. Osseous lesions usually occur in the phalanges of the hands and feet. Involvement of the axial skeleton is more uncommon. Osseous involvement may be asymptomatic. It is often incidentally discovered on imaging modalities. Radiological techniques can reveal sclerotic and/or destructive lesions. We present a case of a 61-year-old woman in whom osseous sarcoidosis of the sacrum was revealed by back pain and sciatica. To our knowledge, only one isolated case of sacral sarcoidosis has been reported in the literature. Sarcoid bone lesions can be present at disease onset without pulmonary involvement. A biopsy is often required in order to eliminate other conditions, especially malignancy. Treatment is not specific and also not needed in a significant number of cases. https://acta.tums.ac.ir/index.php/acta/article/view/8852