ultrasound setting and scanning of the thyroid gland for examining sjogren&#39;s syndrome

Sjogren सिंड्रोम की लार ग्रंथि अल्ट्रासाउंड परीक्षा के लिए तकनीक

Sjogren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration in exocrine glands, including the salivary and lacrimal glands. Xerostomia, keratoconjunctivitis sicca, and extraglandular manifestations, including arthralgia, cytopenia, and lymphoma, are described in patients with SS. SS can be divided into primary and secondary types, in which the latter occurs in association with other connective tissue diseases. In the 2016 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for primary SS, anti-SSA/Ro positivity and lymphocytic infiltration in labial salivary gland biopsy contributed to the two major criteria, whereas Schirmer's test, ocular staining score, and unstimulated salivary flow represented the rest of the minor criteria1. The criteria are summarized in Table 1. Labial biopsy is an invasive procedure with potential complications, including sampling error, sensory loss, and hematoma formation2. Ocular staining tests and salivary flow assessment require specialized settings and might not be widely available. 
Salivary gland ultrasonography (SGUS) is a non-invasive imaging modality that provides a detailed examination of the superficial salivary gland structure, which is commonly affected in patients with SS. Lymphocytic infiltration and inflammation in the salivary glands often lead to fatty infiltration, fibrosis, and loss of parenchyma, resulting in parenchymal inhomogeneity detected in SGUS3. The Outcome Measures in Rheumatology Clinical Trials (OMERACT) working group derived an ultrasound scoring system from grades 0 to 3 to semi-quantify inhomogeneity and the presence of hypoechoic areas within the parotid or submandibular glands4. A cutoff of grade 2 or above in at least one gland was found to correlate with positive labial biopsies, sialometry, and positive autoantibodies5. It demonstrated excellent specificity and good sensitivity in fulfilling the 2016 ACR/EULAR classification criteria for primary SS when given similar weight as the minor criteria. This protocol presents a standardized and practical approach for diagnosing SGUS in SS in clinical settings.

लेखक स्पॉटलाइट: संयोजी ऊतक रोग अनुसंधान में मानकीकृत लार ग्रंथि अल्ट्रासाउंड प्रोटोकॉल पर ध्यान केंद्रित

Sjogren सिंड्रोम के लिए लार ग्रंथियों का अल्ट्रासोनोग्राफिक मूल्यांकन: नैदानिक और निगरानी अंतर्दृष्टि

Our research focus is connective tissue diseases, including Sjogren's syndrome, and we will describe a standardized approach to saliva and ultrasound in diagnosing Sjogren's syndrome. We hope the protocol will be useful for clinicians unfamiliar with doing ultrasound to enhance its application in clinical practice. Ultrasound is a powerful tool in evaluating various rheumatological conditions, including arthritis, sjogren syndrome, and interstitial lung disease.It is helpful in diagnosis, monitoring and prognostication. It can be applied as an outcome measure in clinical studies such as detecting subclinical synovitis to assess the risk of rheumatoid arthritis progression. Ultrasound is an operator-dependent procedure and the result may be unreliable if inexperienced, hence performed.Well validated and quantitative measurements are often needed to standardize the description and reporting of pathological sonographic findings before they can be applied in clinical practice and research. In this procedure, we will describe how to conduct a salivary gland ultrasound in patients with sicker symptoms. This approach is easy to perform and can usually be completed within 10 to 15 minutes.We'll also demonstrate techniques to perform reliable and reproducible results to ensure the quality of the ultrasound scanning. Our center will continue to research on applying ultrasound in diagnosis and monitoring in rheumatology. We will research utilizing lung ultrasound for screening of interstitial lung disease associated with connective tissue diseases, hoping to improve the current screening strategy for lung fibrosis in rheumatology patients.

Sjogren के सिंड्रोम की जांच के लिए थायरॉयड ग्रंथि की अल्ट्रासाउंड सेटिंग और स्कैनिंग

शुरू करने के लिए, 10 मेगाहर्ट्ज़ के उच्च आवृत्ति रैखिक ट्रांसड्यूसर का चयन करें। अल्ट्रासाउंड को बी मोड पर सेट करें और जांच की उच्चतम आवृत्ति का उपयोग करें। गहराई को तीन सेंटीमीटर तक समायोजित करें और 50% से 60% प्राप्त करेंरोगी को लापरवाह स्थिति में गर्दन को थोड़ा बढ़ाया हुआ रखें, रोगी के सिर का समर्थन करने के लिए एक तकिया का उपयोग करें।अनुप्रस्थ छवियों के लिए, रोगी के दाईं ओर इशारा करते हुए मार्कर के साथ जांच उन्मुख. अनुदैर्ध्य स्कैनिंग के लिए, सेफेलिक पक्ष पर मार्कर उन्मुख। जांच की सतह पर जेल लागू करें।थायरॉयड ग्रंथि को स्कैन करने के लिए थायरॉयड उपास्थि के नीचे जांच रखें। प्राप्त छवियों को सहेजें। थायरॉयड ग्रंथि के दाएं और बाएं लोब को जोड़ता है।एक संदर्भ के रूप में एक सामान्य थायरॉयड ग्रंथि की इकोोजेनेसिटी पर विचार करें। किसी भी सहवर्ती थायरॉयड रोग के लिए, आसपास की मांसपेशियों की इकोोजेनेसिटी की तुलना करें।

Research

JoVE Journal

Medicine

Ultrasound Setting and Scanning of the Thyroid Gland for Examining Sjogren&#39;s Syndrome

Ultrasonographic Evaluation of Salivary Glands for Sjogren's Syndrome: Diagnostic and Monitoring Insights

Sjogren's syndrome (SS) is a chronic autoimmune condition commonly affecting the exocrine glands, causing oral or ocular dryness and extraglandular ...

Ultrasound Scanning of the Parotid Gland for Examining Sjogren&#39;s Syndrome

Sjogren के सिंड्रोम की जांच के लिए पैरोटिड ग्रंथि का अल्ट्रासाउंड स्कैनिंग

Ultrasound Scanning of the Submandibular Gland for Examining Sjogren&#39;s Syndrome

Sjogren के सिंड्रोम की जांच के लिए सबमांडिबुलर ग्रंथि का अल्ट्रासाउंड स्कैनिंग