Sarcoidosis - How Is Sarcoidosis Diagnosed? - Diagnosis

Sarcoidosis is diagnosed based on your symptoms, a physical exam and imaging tests or a biopsy. Before diagnosing you with sarcoidosis, your doctor 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 granulomas are located and whether there is scarring on imaging tests. Stage IV is the most severe 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 doctor if you live or work near insecticides or mold or have other risk factors for sarcoidosis. During the physical exam, your doctor may:

• Check your temperature
• Feel different parts of your body 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

To diagnose sarcoidosis, your doctor may have you undergo some of the following tests and procedures:

• Chest X-rays to look for granulomas or scarring in the lungs and heart. This will also help determine the stage of the disease. Often, sarcoidosis is found because a chest X-ray is performed for another reason.
• Biopsies of the skin, lymph nodes, lungs, or other affected organs to diagnose granulomas. This is often needed to confirm your sarcoidosis diagnosis. A bronchoscopy is the procedure used to get the biopsy sample from your lungs or lymph nodes in your chest.
• Blood tests to check your blood counts, hormone levels, and kidney function
• Other imaging tests to look for granulomas or inflammation in the heart, eyes, lymph nodes, or other areas. This may include magnetic resonance imaging (MRI), an ultrasound, a high-resolution computed tomography (CT) scan, a positron electron tomography (PET) scan, or a gallium scan. Many of these tests may use a radioactive material, such as gallium.

Tests to look at how sarcoidosis is affecting the body

• Neurological tests, such as electromyography, evoked potentials, spinal taps, or nerve conduction tests, to find problems with the nervous system caused by sarcoidosis
• Eye exam to look for eye damage, which can occur without symptoms in a person with sarcoidosis
• Pulmonary function tests to check whether you have breathing problems
• Heart tests to 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