#fridayimagechallenge (with answers)

You are on a radiology elective and come across this CXRsarcoidosis-2


answer: Sarcoidosis

great review here https://radiopaedia.org/articles/sarcoidosis-thoracic-manifestations-2

quick hitters:

pulmonary involvement in >90% of cases and responsible for majority of morbidity/mortality

classic CXR distribution is bilateral hilar and right paratracheal nodal enlargement (1-2-3 sign or garland triad, see our image for example)

Staging dictates likelihood of resolution

  • stage 0: normal chest radiograph
    • 5-10% of patients at presentation
  • stage I: hilar or mediastinal nodal enlargement only
    • 45-65% of patients at presentation
      • 60% resolution in 1-2 years
  • stage II: nodal enlargement and parenchymal disease
    • 25-30% of patients at presentation
      • 45% resolution within 1-2 years
  • stage III: parenchymal disease only
    • 15% of patients at presentation
      • 10% resolution within 1-2 years
  • stage IV: end-stage lung (pulmonary fibrosis)


photo credit: radiopaedia