Sarcoidosis Diagnosis

Sarcoidosis is diagnosed based on your symptoms, a physical exam, and imaging tests or a biopsy. Before diagnosing you with sarcoidosis, your healthcare provider will rule out other possible conditions.

Stages of sarcoidosis

Doctors use stages to describe sarcoidosis of the lung or lymph nodes of the chest. The stages are based on where the lumps, or granulomas, are found and whether there is scarring on imaging tests. Stage IV is the most serious and means you have permanent scarring in the lungs.

Medical history and physical exam

Bring a list of symptoms with you to your appointment. Tell your provider if you live or work near insecticides or mold or have other risk factors for sarcoidosis. During the physical exam, your provider may:

  • Check your temperature.
  • Check to see if your lymph nodes, spleen, or liver are swollen.
  • Listen to your chest with a stethoscope as you breathe in and out.
  • Look for rashes or sores on your body, such as scalp and lower legs.

Diagnostic tests and procedures

There are no screening tests to determine who will develop sarcoidosis. If you are at risk for sarcoidosis, your provider may talk to you about trying to avoid certain substances in your environment that can trigger granulomas.

Your healthcare provider may have you undergo certain tests and procedures to diagnose sarcoidosis.

  • Chest X-rays look for granulomas or scarring in the lungs and heart. This will also help figure out the stage of the disease. Often, sarcoidosis is found because a chest X-ray is done for another reason.
  • biopsy  of the skin, lymph nodes, lungs, or other affected organs may help confirm your sarcoidosis diagnosis. Your doctor will do a bronchoscopy to get the biopsy sample from your lungs or lymph nodes in your chest.
  • Blood tests check your blood counts, hormone levels, and how well your kidneys are working.
  • Other imaging tests look for granulomas or inflammation in the heart, eyes, lymph nodes, or other areas. These may include magnetic resonance imaging (MRI) or an ultrasound.

The tests below look at how sarcoidosis is affecting the body.

  • Neurological tests, such as electromyography, evoked potentials, spinal taps, or nerve conduction tests, look for problems with the nervous system caused by sarcoidosis.
  • Eye exams look for eye damage, which can occur without symptoms in a person with sarcoidosis.
  • Lung function tests check whether you have breathing problems.
  • Heart tests monitor how well your heart is working. Sarcoidosis only rarely affects the heart, but cardiac sarcoidosis may be life threatening. Tests may include electrocardiography (ECG or EKG), echocardiography, or cardiac MRI.
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