The chest x-rays show bilateral hilar adenopathy. The lateral chest x-ray shows a ‘Donut Sign’ due to the end on left upper lobe bronchus visible through the densely placed hilar lymph nodes.

The patient has a subset of sarcoidosis called Lofgren Syndrome observed in less than 10% of patients with sarcoidosis. The syndrome is a combination of hilar adenopathy, erythema nodosum, poly arthralgia & fever seen primarily in women. Men may present with bilateral ankle arthropathy but without erythema nodosum.

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