Scheme of Gibson et al for Grading the Chest X-Ray of a Patient with Pulmonary Sarcoidosis

 

Patient selection: pulmonary sarcoidosis

 

Examination: chest X-ray

 

Types of shadows seen:

(1) reticulonodular (R)

(2) macronodular (M)

(3) confluent (C)

(4) fibrotic (F)

 

Shadowing	Features
reticulonodular	small round or fine linear opacities with mean diameter < 5 mm
macronodular	discrete nodules with mean diameter >= 5 mm
confluent	homogenous alveolar shadowing that looks like consolidation
fibrotic	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)

 

Interpretation:

• 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).