Gibson et al reported a method for reporting changes in a chest X-ray seen in a patient with pulmonary sarcoidosis. This can be used to monitor the patient over time. The authors are from the Sarcoidosis Subcommittee of the Research Committee of the British Thoracic Society.


Patient selection: pulmonary sarcoidosis


Examination: chest X-ray


Types of shadows seen:

(1) reticulonodular (R)

(2) macronodular (M)

(3) confluent (C)

(4) fibrotic (F)





small round or fine linear opacities with mean diameter < 5 mm


discrete nodules with mean diameter >= 5 mm


homogenous alveolar shadowing that looks like consolidation


irregular linear opacities that are persistent over time; may show distortion of the normal vasculature, cysts or bullae, or contraction of lung tissue


Each type of shadow is scored from 0 to 4 for its:

(1) extent

(2) profusion (quantity)


subscore for each shadow type =

= (points for extent) * (points for profusion)


total score =

= SUM(all 4 subscores)



• minimum subscore or total score : 0

• maximum subscore: 16

• maximum total score: 64 (in practice this would be less since any one extensive process would mask the others).


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