Sarcoidosis physical examination: Difference between revisions
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In half of the patients diagnosed with [[sarcoidosis]], the disease is found incidentally by a [[CXR]] ([[bilateral hilar lymphadenopathy]], [[reticular opacities]]) before the symptoms develop. Lung is the most common organ involved by [[sarcoidosis]], but up to 30% percent of patients present with [[extra-pulmonary manifestations of sarcoidosis]]. The most common pattern of lung involvement in [[sarcoidosis]] is [[interstitial lung disease]] (other less common pulmonary manifestations include [[pneumothorax]], [[pleural thickening]], [[chylothorax]], [[pulmonary hypertension]])<ref>Ungprasert P, Carmona EM, Utz JP, Ryu JH, Crowson CS, Matteson EL: Epidemiology of Sarcoidosis 1946-2013: A Population-Based Study. Mayo Clinic proceedings 2016, 91(2):183-188.</ref><ref>Baughman RP, Teirstein AS, Judson MA, Rossman MD, Yeager H, Jr., Bresnitz EA, DePalo L, Hunninghake G, Iannuzzi MC, Johns CJ et al: Clinical characteristics of patients in a case control study of sarcoidosis. American journal of respiratory and critical care medicine 2001, 164(10 Pt 1):1885-1889.</ref><ref>Rizzato G, Tinelli C: Unusual presentation of sarcoidosis. Respiration; international review of thoracic diseases 2005, 72(1):3-6.</ref>. | In half of the patients diagnosed with [[sarcoidosis]], the disease is found incidentally by a [[CXR]] ([[bilateral hilar lymphadenopathy]], [[reticular opacities]]) before the symptoms develop. Lung is the most common organ involved by [[sarcoidosis]], but up to 30% percent of patients present with [[extra-pulmonary manifestations of sarcoidosis]]. The most common pattern of lung involvement in [[sarcoidosis]] is [[interstitial lung disease]] (other less common pulmonary manifestations include [[pneumothorax]], [[pleural thickening]], [[chylothorax]], [[pulmonary hypertension]])<ref>Ungprasert P, Carmona EM, Utz JP, Ryu JH, Crowson CS, Matteson EL: Epidemiology of Sarcoidosis 1946-2013: A Population-Based Study. Mayo Clinic proceedings 2016, 91(2):183-188.</ref><ref>Baughman RP, Teirstein AS, Judson MA, Rossman MD, Yeager H, Jr., Bresnitz EA, DePalo L, Hunninghake G, Iannuzzi MC, Johns CJ et al: Clinical characteristics of patients in a case control study of sarcoidosis. American journal of respiratory and critical care medicine 2001, 164(10 Pt 1):1885-1889.</ref><ref>Rizzato G, Tinelli C: Unusual presentation of sarcoidosis. Respiration; international review of thoracic diseases 2005, 72(1):3-6.</ref>. | ||
* Crackles are not commonly auscultated on lung examination. Wheezing may be heard when there is endobronchial involvement. | * [[Crackles]] are not commonly auscultated on lung examination. [[Wheezing]] may be heard when there is endobronchial involvement. | ||
* In 8 to 15 year-old children, the disease presentation is similar to adults but younger children present with skin rash, arthritis, and red eye(uveitis). 90% of the children have an abnormal CXR<ref>Nathan N, Marcelo P, Houdouin V, Epaud R, de Blic J, Valeyre D, Houzel A, Busson PF, Corvol H, Deschildre A et al: Lung sarcoidosis in children: update on disease expression and management. Thorax 2015, 70(6):537-542.</ref>< | * In 8 to 15 year-old children, the disease presentation is similar to adults but younger children present with [[skin rash]], [[arthritis]], and red eye([[uveitis]]). 90% of the children have an abnormal [[CXR]]<ref>Nathan N, Marcelo P, Houdouin V, Epaud R, de Blic J, Valeyre D, Houzel A, Busson PF, Corvol H, Deschildre A et al: Lung sarcoidosis in children: update on disease expression and management. Thorax 2015, 70(6):537-542.</ref><ref>Pattishall EN, Kendig EL, Jr.: Sarcoidosis in children. Pediatric pulmonology 1996, 22(3):195-203.</ref><ref>Milman N, Hoffmann AL: Childhood sarcoidosis: long-term follow-up. The European respiratory journal 2008, 31(3):592-598.</ref>. | ||
===Gallery=== | ===Gallery=== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]
Overview
Physical examination
Pulmonary Sarcoidosis
In half of the patients diagnosed with sarcoidosis, the disease is found incidentally by a CXR (bilateral hilar lymphadenopathy, reticular opacities) before the symptoms develop. Lung is the most common organ involved by sarcoidosis, but up to 30% percent of patients present with extra-pulmonary manifestations of sarcoidosis. The most common pattern of lung involvement in sarcoidosis is interstitial lung disease (other less common pulmonary manifestations include pneumothorax, pleural thickening, chylothorax, pulmonary hypertension)[1][2][3].
- Crackles are not commonly auscultated on lung examination. Wheezing may be heard when there is endobronchial involvement.
- In 8 to 15 year-old children, the disease presentation is similar to adults but younger children present with skin rash, arthritis, and red eye(uveitis). 90% of the children have an abnormal CXR[4][5][6].
Gallery
Skin
Head
Neck
Extremities
References
- ↑ Ungprasert P, Carmona EM, Utz JP, Ryu JH, Crowson CS, Matteson EL: Epidemiology of Sarcoidosis 1946-2013: A Population-Based Study. Mayo Clinic proceedings 2016, 91(2):183-188.
- ↑ Baughman RP, Teirstein AS, Judson MA, Rossman MD, Yeager H, Jr., Bresnitz EA, DePalo L, Hunninghake G, Iannuzzi MC, Johns CJ et al: Clinical characteristics of patients in a case control study of sarcoidosis. American journal of respiratory and critical care medicine 2001, 164(10 Pt 1):1885-1889.
- ↑ Rizzato G, Tinelli C: Unusual presentation of sarcoidosis. Respiration; international review of thoracic diseases 2005, 72(1):3-6.
- ↑ Nathan N, Marcelo P, Houdouin V, Epaud R, de Blic J, Valeyre D, Houzel A, Busson PF, Corvol H, Deschildre A et al: Lung sarcoidosis in children: update on disease expression and management. Thorax 2015, 70(6):537-542.
- ↑ Pattishall EN, Kendig EL, Jr.: Sarcoidosis in children. Pediatric pulmonology 1996, 22(3):195-203.
- ↑ Milman N, Hoffmann AL: Childhood sarcoidosis: long-term follow-up. The European respiratory journal 2008, 31(3):592-598.