Neuromyelitis optica spectrum disorder chest x ray
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Julinka Auta Fernandes
Overview
Chest X-ray findings are not included in the international consensus diagnostic criteria for neuromyelitis optica spectrum disorder (NMOSD). Accordingly, chest X-ray alone cannot confirm or exclude NMOSD.[1][2]
Key Chest X-Ray Findings in Neuromyelitis Optica Spectrum Disorder
In suspected neuromyelitis optica spectrum disorder, chest X-ray may be useful when the clinical evaluation raises concern for an alternative thoracic or systemic disorder, particularly sarcoidosis.[3][4]
- Reason for considering sarcoidosis: Neurosarcoidosis can mimic NMOSD. This differential diagnosis deserves particular attention when testing for aquaporin-4 immunoglobulin G (AQP4-IgG) and myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG) is negative.[3]
- Indication for chest X-ray: The British Thoracic Society (BTS) clinical statement recommends a chest X-ray when sarcoidosis is suspected.[4]
- Findings that may suggest sarcoidosis: These include symmetric enlargement of hilar lymph nodes on both sides, mediastinal lymphadenopathy, and nodular or reticulonodular pulmonary opacities predominantly involving the middle and upper lung zones. Interpret these findings together with the clinical assessment for sarcoidosis.[4]
- Limitations: A normal chest X-ray does not exclude sarcoidosis. Persistent clinical suspicion warrants further evaluation.[4]
References
- ↑ Wingerchuk DM, Banwell B, Bennett JL, et al. (2015). "International consensus diagnostic criteria for neuromyelitis optica spectrum disorders". Neurology. 85 (2): 177–189. doi:10.1212/WNL.0000000000001729. PMC 4515040. PMID 26092914.
- ↑ Yamout B, Gouider R, Al-Roughani R, et al. (2026). "Consensus Recommendations for the Diagnosis and Treatment of Neuromyelitis Optica Spectrum Disorders (NMOSD): The MENACTRIMS Guidelines". CNS Drugs. 40 (3): 283–303. doi:10.1007/s40263-025-01260-x. PMID 41591715 Check
|pmid=value (help). - ↑ 3.0 3.1 Jarius S, Aktas O, Ayzenberg I, et al. (2023). "Update on the diagnosis and treatment of neuromyelits optica spectrum disorders (NMOSD) – revised recommendations of the Neuromyelitis Optica Study Group (NEMOS). Part I: Diagnosis and differential diagnosis". Journal of Neurology. 270 (7): 3341–3368. doi:10.1007/s00415-023-11634-0. PMC 10267280 Check
|pmc=value (help). PMID 37022481 Check|pmid=value (help). - ↑ 4.0 4.1 4.2 4.3 Thillai M, Atkins CP, Crawshaw A, et al. (2021). "BTS Clinical Statement on pulmonary sarcoidosis". Thorax. 76 (1): 4–20. doi:10.1136/thoraxjnl-2019-214348. PMID 33268456 Check
|pmid=value (help).