How would you manage asymptomatic osseous sarcoidosis of the lumbar spine without any other systemic involvement?

Some patients with sarcoidosis are found to have bone-related abnormalities. These are frequently incidental findings often detected as a phantom abnormality on PET or MR scan without corresponding X-ray or CT abnormality; this suggests they are foci of inflammation localized within bone marrow and typically do not cause destructive bony lesions. If the initial finding was on a PET scan, obtaining an MR scan would be helpful to see if MR could be used for longer term monitoring (without radiation). A trial of therapy may be useful to demonstrate that these lesions behave appropriately and do not grow when treated with low dose prednisone (10 - 20 mg daily). In patients with a prior history of cancer these lesions can pose a significant dist...