Thoracic sarcoidosis (staging)
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Pulmonary sarcoidosis can be staged on a chest radiograph with implications for prognosis.
Classification
Scadding criteria
On PA chest radiographs, sarcoidosis can be classified into five stages 1,2,6:
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stage 0: normal chest radiograph
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5-10% of patientsfrequency at presentation: 5-15%
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stage I: hilar or mediastinal nodal enlargement only
45-65% of patients at presentation60% go onto a complete resolution
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stage II: nodal enlargement and parenchymal disease
- 25-30% of patients at presentation
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stage III: parenchymal disease only
- 15% of patients at presentation
- stage IV: end-stage lung (pulmonary fibrosis)
Although in general patients progress from one stage to the next this system does not correlate particularly well with clinical severity 1,2. In fact, chest x-ray appearances often are more dramatic than functional impairment 2.
History and etymology
In 1961, Scadding published a classification system adapted from one initially proposed by Karl Warm 4. Sometimes sarcoidosis is described as being staged with Siltzbach classification system 3, although this paper was not published until 1967 5, and in turn, makes reference to classification systems already in place.
-<p><strong>Pulmonary</strong> <strong>sarcoidosis</strong> can be <strong>staged</strong> on a chest radiograph with implications for prognosis. </p><h4>Classification</h4><h5>Scadding criteria</h5><ul>- +<p><strong>Pulmonary</strong> <strong>sarcoidosis</strong> can be <strong>staged</strong> on a chest radiograph with implications for prognosis. </p><h4>Classification</h4><h5>Scadding criteria</h5><p>On <a title="PA chest radiographs" href="/articles/chest-radiograph">PA chest radiographs</a>, sarcoidosis can be classified into five stages <sup>1,2,6</sup>:</p><ul>
-<strong>stage 0:</strong> normal chest radiograph<ul><li>5-10% of patients at presentation</li></ul>- +<strong>stage 0:</strong> normal chest radiograph<ul><li>frequency at presentation: 5-15%</li></ul>
-<strong>stage I:</strong> hilar or mediastinal nodal enlargement only<ul>-<li>45-65% of patients at presentation</li>-<li>60% go onto a complete resolution</li>-</ul>-</li>- +<strong>stage I:</strong> hilar or mediastinal nodal enlargement only</li>
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