Organ system | Findings highly probable for sarcoidosis (3 points) | Findings somewhat probable for sarcoidosis (2 points) |
Lungs | Any of the following:
| Any of the following:
|
Brain/nerve | Clinical syndrome consistent with granulomatous inflammation of the neurologic system and An abnormal MRI or CSF findings characteristic of neurosarcoidosis | Isolated facial palsy, negative MRI or Clinical syndrome consistent granulomatous inflammation of the neurologic system without characteristic MRI or CSF findings |
Nonthoracic lymph node | Multiple enlarged palpable cervical or epitrochlear lymph nodes without B symptoms or Enlarged lymph nodes identified by imaging in at least 2 peripheral or visceral lymph node stations without B symptoms | |
Kidney | Treatment-responsive renal failure without alternative diagnosis | |
Heart | Any of the following:
| |
Skin | Lupus pernio | Any of the following:
|
Eyes | Any of the following:
| Any of the following:
|
Liver | Any of the following:
| |
Bone marrow | PET displaying diffuse uptake | |
Spleen | Any of the following:
| |
Bone/joints | Typical radiographic features (trabecular pattern, osteolysis, cysts/punched out lesions) | Any of the following:
|
Ear/nose/throat | Granulomatous changes on direct laryngoscopy or Consistent imaging studies (eg, sinonasal erosion, mucoperiosteal thickening, positive PET scan) | |
Parotid/salivary glands | Positive gallium-67 scan ("Panda sign") or Positive PET scan of the parotid glands | Symmetrical parotitis with syndrome of mumps or Enlarged salivary glands |
Muscles | Positive imaging (MRI, Gallium-67) or Palpable muscle masses | |
Endocrine | Hypercalcemia or hypercalciuria plus all of the following:
| Nephrolithiasis plus all of the following:
or Hypercalciuria without serum PTH and 25 and 1,25 vitamin D levels or Nephrolithiasis with calcium stones (without serum PTH and 25 and 1,25 vitamin D levels) |
The clinical sarcoidosis diagnosis score (SDS) requires assessing highly probable or somewhat probable findings for sarcoidosis that do not have an alternative explanation. Using the table above, 3 points are awarded for each highly probable finding and 2 for each somewhat probable finding; no additional points are awarded for multiple findings within a single organ system. A tabulated SDS score ≥10 has shown good specificity (>99%) for the diagnosis of sarcoidosis and may obviate the need for invasive biopsy in some cases.[1]
For additional details, refer to UpToDate topics on the diagnosis of sarcoidosis.Adapted with permission from: Judson MA, Costabel U, Drent M, et al. The WASOG Sarcoidosis Organ Assessment Instrument: An update of a previous clinical tool. Sarcoidosis Vasc Diffuse Lung Dis 2014; 31:19.
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