Salivary gland ultrasonography as a screening method for sjogren's syndrome

ABSTRACT

To evaluate the usefulness and reliability of high resolution ultrasonography [US] as a safe and non-invasive method for screening the salivary glands to diagnose Sjogren's syndrome [SS] in patients with rheumatoid arthritis and other autoimmune connective tissue disorders attending the Rheumatology Clinic, Al-Amiri Hospital, Kuwait. Forty-five patients with rheumatoid arthritis and 20 patients with other connective tissue disorders, 10 patients with primary SS, and 25 healthy normal individuals, were included in the study US examination of the salivary glands was performed using a linear real time 7.5 MHz probe. Sialography incisional labial salivary gland biopsy excisional parotid gland biopsy as well as specific immunological tests, were performed in many patients. Normal salivary glands were distinctly homogeneous, while salivary glands involved with SS showed a heterogenous echotextural pattern caused by the presence of diffusely scattered focal hypoechogenic areas. These areas represented diffusely scattered aggregates of focal lympho-epithelial infiltrations, considered to be the specific histologic markers of SS, as well as sialectatic sacculations. Depending on the degree of echotextural heterogenity of the salivary glands, SS was classified as either definite or early The prevalence of SS among patients with rheumatoid arthritis was sonographically definite in 60% and early in 20%, while the prevalence among patients with other connective tissue disorders was definite in 10% and early in 25%!. US of the salivary glands is a useful and reliable screening method for detecting and monitoring the progression of salivary gland involvement in Sjogren's syndrome