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How Is Sarcoidosis Diagnosed?

Your doctor will find out if you have sarcoidosis by taking a detailed medical history and conducting a physical exam and several diagnostic tests. The purpose is to:

  • Identify the presence of granulomas in any of your organs
  • Rule out other causes of your symptoms
  • Determine the amount of damage to any of your affected organs
  • Determine whether you need treatment.
  • Medical History

    Your doctor will ask you for a detailed medical history. He or she will want to know about any family history of sarcoidosis and what jobs you have had that may have increased your chances of getting sarcoidosis.

    Your doctor may also ask whether you have ever been exposed to inhaled beryllium metal, which is used in aircraft and weapons manufacture, or organic dust from birds or hay. These things can produce granulomas in your lungs that look like the granulomas that are caused by sarcoidosis but are actually signs of other conditions.

    Physical Exam

    Your doctor will look for symptoms of sarcoidosis, such as red bumps on your skin; swollen lymph nodes; an enlarged liver, spleen, or salivary gland(s); or redness in your eyes. He or she will also listen for abnormal lung sounds or heart rhythm. Your doctor also will check for other likely causes of your symptoms.

    Diagnostic Tests

    There is no one specific test for diagnosing sarcoidosis. It is harder to diagnose sarcoidosis in some organs (e.g., heart, nervous system) than in others. Your doctor will probably conduct a variety of tests and procedures to help in the diagnosis.

    These include:

  • Chest X Ray. A chest x ray takes a picture of your heart and lungs. It may show granulomas or enlarged lymph nodes in your chest. About 95 out of every 100 people who have sarcoidosis have an abnormal chest x ray.
  • Doctors usually use a staging system for chest x rays taken to detect sarcoidosis:
  • Stage 0: Normal chest x ray
  • Stage 1: Chest x ray showing enlarged lymph nodes but otherwise clear lungs
  • Stage 2: Chest x ray showing enlarged lymph nodes and shadows in your lungs
  • Stage 3: Chest x ray showing shadows in your lungs, but the lymph nodes are not enlarged
  • Stage 4: Chest x ray showing scars in the lung tissue.
  • In general, the higher the stage of the x ray, the worse your symptoms and lung function are. But there are a lot of differences among people. If your x-ray results show Stages 0, 1, 2, or 3, you may not have symptoms or need treatment, and you may get better and have normal chest x rays again over time.
  • Blood Tests. These tests can show the number and type of cells in your blood. They also will show whether there are increases in your calcium levels or changes in your liver, kidney, and bone marrow that can occur with sarcoidosis.
  • Lung Function Tests. One test uses a spirometer (spi-rom'e-ter), a device that measures how much and how fast you can blow air out of your lungs after taking a deep breath. If there is a lot of inflammation and/or scarring in your lungs, you will not be able to move normal amounts of air in and out.
  • Another test measures how much air your lungs can hold. Sarcoidosis can cause your lungs to shrink, and they will not be able to hold as much air as healthy lungs.
  • Next Diagnosis page of Sarcoid