British Journal of Rheumatology 1996;35:972-977 PAROTID GLAND ULTRASONOGRAPHY AS A DIAGNOSTIC TOOL IN PRIMARY SJOGREN'S SYNDROME

The diagnostic value of parotid gland ultrasonography (Acuson 128, 7 MHz transducer) was studied in 62 patients with primary Sjogren's syndrome (SS) and in 69 controls of similar age and sex distribution. Different degrees (mild, evident or gross) of parenchymal inhomogeneity (PIH) were the most important sonographic changes in SS; they occurred in 83.9 % of the patients. The sonographic results (the presence or absence of PIH) were in accordance with the parotid sialographic and scintigraphic findings and the histology of the minor salivary glands in 87.3, 84.7 and 84.3 % of the cases, respectively. Of the degrees of PIH, only evident and gross PIH are thought to be of true diagnostic value for SS. On the basis of the good agreement between the sonographic and sialographic results, consideration of the introduction of parotid sonography as an alternative to sialography is suggested in SS if the latter method cannot be performed. KEY WORDS: Primary Sjogren's syndrome, Parotid gland ultrasonography, Parenchymal inhomogeneity. SUBJECTIVE xerostomia is one of the main symptoms of primary Sjogren's syndrome (SS) [1,2]. It is often the first complaint to present, but the disease can also begin with systemic (articular, vascular, lung, etc.) symptoms [3, 4]. The xerostomia in SS is a consequence of the reduced saliva production caused by the chroni