Abstract
A 31-year-old woman had been developing a gradually worsening general fatigue and cough over the past 2 years. In an orthopedic clinic, spinal magnetic resonance imaging (MRI) revealed an incidental finding of left hilar lymphadenopathy, which was also shown on her chest radiograph. She had no spontaneous pain, joint pain, numbness, or weight loss. Her vital signs were normal. On physical examination, no abnormal findings of tenderness and swelling of joints, palpable superficial lymph nodes, or skin rashes were found. An open question revealed general fatigue and cough, and an additional closed question revealed her ocular symptoms. No abnormal laboratory findings were noted. Through endobronchial ultrasonography-guided transbronchial needle aspiration, we diagnosed her with sarcoidosis. Physicians should consider the possibility of sarcoidosis in young patients with asymmetrical hilar lymphadenopathy. Closed questions assuming specific diseases can help provide an accurate diagnosis, since asking open questions exclusively may not reveal all of the patient’s symptoms to the physician.
