title: Chest Radiographic Screening for Sarcoidosis in the Diagnosis of Patients with Active Uveitis.
abstract: BACKGROUND
  Although chest radiography is currently recommended for the initial evaluation of patients with new-onset uveitis, the efficacy of this diagnostic screening modality is not known.
  
  
  OBJECTIVE
  To evaluate the diagnostic value of chest radiographs in patients with active uveitis of recent onset in a tertiary center in Western Europe.
  
  
  METHODS
  A retrospective cross-sectional study was conducted by reviewing all chest imaging for adults with new-onset (<1 yr) uveitis of unknown origin undergoing initial evaluation in the Department of Ophthalmology at Erasmus University Medical Center (Rotterdam, the Netherlands). Radiographic findings were related to clinical and other imaging characteristics and to final diagnoses.
  
  
  RESULTS
  Screening chest radiographs were abnormal for 30 of 200 patients (15%) included in this study. Twenty-two of the 200 patients (11%) had biopsy-confirmed sarcoidosis, and an additional 12 patients were presumed to have sarcoidosis. The finding of chest radiographic abnormalities interpreted as typical of sarcoidosis was specific (91%; 95% confidence interval, 85.9-94.4%) but not sensitive (64%; 95% confidence interval, 43.0-80.3%) for biopsy-confirmed sarcoidosis. The combination of elevated serum angiotensin-converting enzyme level and chest radiographic findings typical of sarcoidosis increased the sensitivity to 79%. Biopsy-confirmed sarcoidosis was more common in patients with panuveitis (17 of 84; 20%) compared to patients with other anatomical locations of uveitis (5 of 116, 4%; P < 0.001). One patient was diagnosed with active pulmonary and ocular tuberculosis.
  
  
  CONCLUSIONS
  Abnormal chest radiographs were found in 15% of patients with active uveitis of unknown origin and onset within 1 year of referral to a tertiary center in the Netherlands. A majority of the abnormal chest radiographs showed findings compatible with a diagnosis of sarcoidosis.
authors.affiliation: 1 Department of Ophthalmology, and.
authors.forename: Fahriye
authors.initials: F
authors.lastname: Groen
authors.affiliation: 2 Department of Internal Medicine and Department of Immunology, Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands.
authors.forename: Jan A M
authors.initials: JAM
authors.lastname: van Laar
authors.affiliation: 1 Department of Ophthalmology, and.
authors.forename: Aniki
authors.initials: A
authors.lastname: Rothova
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D012680:Sensitivity and Specificity; D062606:Tertiary Care Centers; D014605:Uveitis / Q000150:complications*
keywords: diagnostic techniques and procedures; sarcoidosis; uveitis