Which investigations should be prioritized in the assessment of suspected sarcoidosis?

Investigations to prioritize in suspected sarcoidosis include:

• Chest X-ray to assess pulmonary involvement and staging.
• High-resolution computed tomography (CT) scan of the thorax to confirm diagnosis and evaluate extent of lung disease.
• Bronchoscopy with tissue biopsy to obtain histological confirmation.
• Other tissue biopsies as indicated by organ involvement to confirm diagnosis.
• Positron emission tomography (PET) and magnetic resonance imaging (MRI) scans to determine disease severity and identify extrapulmonary involvement.
• Echocardiogram if cardiac involvement is suspected, followed by cardiovascular magnetic resonance (CMR) or PET scans for further evaluation.
• Baseline ophthalmologic assessment if ocular involvement is suspected.
• Lung function tests to assess respiratory impairment.

These investigations help confirm the diagnosis, assess severity, and identify extrapulmonary disease, guiding specialist referral and management ¹.