Session Title: Imaging of Rheumatic Diseases I: Imaging in Gout, Pediatric, Soft and Connective Tissue Diseases
Session Type: Abstract Submissions (ACR)
Background/Purpose: There is increasingly scientific evidence of salivary gland ultrasonography accuracy and usefulness in diagnosing Sjogren Syndrome. [1-2]
Methods: 82 patients with suspected Sjogren Syndrome from a single center were evaluated. Demographic (age and sex), clinical (sicca syndrome, artralgia), ultrasonographic (salivary gland ultrasound following the score proposed by Ariji et al , serologic (anti nuclear antibodies – ANA, anti ENA, anti HCV) and histological (salivary glands biopsy with Chisholm-Mason score evaluation) features were analyzed. Patients were classified according to ACR/EULAR criteria for SS (AEC).
Results: all patients with HCV infection were counted out as well as all the patients with one of the exclusion criteria present in the Primary Sjogren Syndrome classification. Male/female ratio was 1/9; 91.2 % of patients presented xerostomia, 75% xerophthalmia. Schirmer test was positive in 72% of the patients; break up time positive in 65%. The biopsy was positive (Chisholm and Mason score >1) in 61% and ultrasound was positive (score ≥2 out of 4) in 40.2%. ENA test (SSA andor SSB) was positive in 37.4%. The diagnosis of Sjogren Syndrome has been assessed, according to AECG classification criteria, in 36 patients out of 82 (43.9%). 80.6% of patients with positive ultrasound were classified as affected by Sjogren Syndrome, 89.1% of patients with negative ultrasound didn’t fill the classification criteria. The ultrasound score presented a positive likelihood ratio of 4.58 (95% confidence interval 2.34
Conclusion: in our experience salivary gland ultrasound seems to be an useful tool in the diagnostic process of Sjogren Syndrome due to its good sensibility and specificity. Moreover the exam is simple to perform, fast, incruent and well accepted by patients.
- Cornec D et al. Contribution of salivary gland ultrasonography to the diagnosis of Sjögren’s syndrome: Toward new diagnostic criteria? Arthritis Rheum. 2013 Jan;65(1):216-25.
- Milic V. et al. Ultrasonography of major salivary glands could be an alternative tool to sialoscintigraphy in the American-European classification criteria for primary Sjogren’s syndrome. Rheumatology (Oxford). 2012 Jun;51(6):1081-5
- Ariji Y, Ohki M, Eguchi K, et al. Texture analysis of sonographic features of the parotid gland in Sjögren’s syndrome. AJR Am J Roentgenol 1996;166:935–41.
- Vitali C, Bombardieri S, Jonsson R, et al. Classifi cation criteria for Sjögren’s syndrome: a revised version of the European criteria proposed by the American- European Consensus Group. Ann Rheum Dis 2002;61:554–8.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-role-of-salivary-gland-ultrasound-in-sjogren-syndrome-a-single-center-experience/