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Biopsies and bronchoalveolar lavage samples were negative for microbiology, including mycobacterial culture. Pathology demonstrated non-caseating granulomas consistent with a diagnosis of sarcoidosis. Weeks later, he developed arthralgias of the left metacarpophalangeal joints and erythema nodosum and was diagnosed with L\u00f6fgren syndrome, a phenomenon rarely described in the paediatric population. This case highlights an approach to lower extremity swelling as well as hilar lymphadenopathy in the paediatric population. In addition, it emphasises the importance of multidisciplinary teamwork for accurate and timely diagnoses.<\/jats:p>","DOI":"10.1136\/bcr-2020-239434","type":"journal-article","created":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T13:30:27Z","timestamp":1614951027000},"page":"e239434","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Bilateral leg swelling as the presenting symptom of L\u00f6fgren syndrome in a paediatric patient: a rare presentation of a rare paediatric disease"],"prefix":"10.1136","volume":"14","author":[{"given":"Bailey","family":"Komishke","sequence":"first","affiliation":[{"name":"Pediatrics, Stollery Children's Hospital, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica L","family":"Foulds","sequence":"additional","affiliation":[{"name":"Pediatrics, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamara","family":"McMillan","sequence":"additional","affiliation":[{"name":"Pediatric Rheumatology, Stollery Children's Hospital, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7108-3785","authenticated-orcid":false,"given":"Nicholas","family":"Avdimiretz","sequence":"additional","affiliation":[{"name":"Pediatric Respirology, Stollery Children's Hospital, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,3,4]]},"reference":[{"key":"2025082708105860000_14.3.e239434.1","first-page":"119","article-title":"The clinical course of sarcoidosis: presentation, diagnosis, and treatment in a large white and black cohort in the United States","volume":"29","author":"Judson","year":"2012","journal-title":"Sarcoidosis Vasc Diffuse Lung Dis"},{"key":"2025082708105860000_14.3.e239434.2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-0496(199609)22:3<195::AID-PPUL9>3.0.CO;2-O"},{"key":"2025082708105860000_14.3.e239434.3","first-page":"685","article-title":"Sarcoidosis of early onset. 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