A 39 year-old woman presented with this nodular rash and an insidious onset of shortness of breath. A chest X-ray was obtained as shown above. What is abnormal finding on the chest x-ray and what is the syndrome that culminates the imaging finding and rash together?
Image of the Week - Löfgren Syndrome
This is Lӧfgren Syndrome, which is the manifestation of Sarcoidosis which includes
erythema nodosum, hilar adenopathy, and arthritis. With this very specific
presentation, a diagnosis of Sarcoidosis can be made without a biopsy.
Fortunately, this form of Sarcoidosis has an excellent prognosis and can be
managed with NSAIDs.
See more cases like this on Figure 1.
More FOAMed Resources:
Another great case of erythema nodosum and some clinical exam pearls: Diagnoses on Sight: Bilateral Leg Rash @ ALiEM
Great refresh on the reading a standard CXR: How to Read a Chest Xray @ EM REMS
Sarcoid can give you a low low voltage on ECG, but so can other entities: Great ECG of the Week with Amal Mattu on syncope in a patient with low voltage on EKG.