Is it possible to have a clear chest x-ray with sarcoid?

Yes: Sarcoidosis is an inflammatory condition that can involve multiple organ symptoms, not just the lungs. It can involve the liver and small bowel. Lung involvement usually first shows up as enlargement of lymph nodes. Minimal enlargement may not show up on a chest x-ray , but will usually be apparent on a ct scan, particularly if it is performed after injection of an iodine-based contrast agent.

Yes: Sarcoid can cause problems outside of the chest such as in the bones, eyes or skin without causing a problem in the chest. The chest is usually abnormal, but the abnormalities may be too subtle to see on a chest x-ray.

Yes: Pulmonary sarcoidosis may be classified on a chest radiograph into 5 stages. Stage 0: normal chest radiograph 5-10% of patients at presentation.

Yes,: that is considered stage 0, in a relatively small percentage of cases.