Video

Salivary gland ultrasound is accurate diagnostic tool for Sjögren’s


 

REPORTING FROM THE EULAR 2018 CONGRESS

AMSTERDAM – Ultrasound of the salivary glands is a readily available and inexpensive tool for the diagnosis of Sjögren’s syndrome, according to a study that evaluated this test in relation to the recent American College of Rheumatology and European League Against Rheumatism (ACR/EULAR) classification criteria.

In a video interview, Esther-Jellina Mossel reported that the sensitivity and specificity of a Sjögren’s syndrome diagnosis is essentially unchanged when ultrasound replaces a positive ocular staining score, the Schirmer test, or an unstimulated whole saliva flow test, without reducing diagnostic accuracy.

The sensitivity of the diagnosis is reduced only if ultrasound is used to replace either of the two remaining ACR/EULAR criteria, which are a labial gland biopsy or an anti-SSA antibody test. In relation to the three criteria that it can replace without loss of diagnostic accuracy, ultrasound might have advantages.

“People who don’t have access to an ophthalmologist performing an ocular staining score, for instance, could use an ultrasound of the salivary glands instead of the ocular staining score and still make a diagnosis,” said Ms. Mossel, a PhD student in the department of rheumatology at the University of Groningen (the Netherlands).

Ultrasound, which is commonly used to evaluate joints of patients with inflammatory diseases, is available in the offices of most rheumatologists, according to Ms. Mossel. She estimated that the evaluation of the salivary glands, which reveals characteristic hypoechogenic areas when Sjögren’s syndrome is present, takes about 10 minutes.

At Ms. Mossel’s center, ultrasound has already become a standard tool for the diagnosis of Sjögren’s syndrome. She said that other centers have also found this imaging tool to be accurate and useful for Sjögren’s syndrome diagnosis.

Based on the experience at the University of Groningen, Ms. Mossel believes that ultrasound will eventually be widely adopted for Sjögren’s syndrome diagnosis. Indeed, she expects that this strategy is likely to be added to the ACR/EULAR diagnostic criteria when its accuracy becomes more generally recognized.

Recommended Reading

Cutaneous lupus: Switching antimalarials can delay immunosuppressive therapy
MDedge Rheumatology
Long-term follow-up most important for hydroxychloroquine retinal screening
MDedge Rheumatology
Pemphigus remission rate tops 80% with rituximab
MDedge Rheumatology
EULAR scientific program highlights spectrum of translational research
MDedge Rheumatology
Baricitinib shows potential as lupus treatment
MDedge Rheumatology
LLDAS shows potential as routine lupus treatment target
MDedge Rheumatology
FDA database reveals many rheumatic and musculoskeletal adverse events on immunotherapies
MDedge Rheumatology
Low vitamin D linked with DVT in lupus patients
MDedge Rheumatology
SLE classification criteria perform well in validation study
MDedge Rheumatology
New SLE classification criteria reset disease definition
MDedge Rheumatology