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

Tecnica per l'esame ecografico delle ghiandole salivari della sindrome di Sjogren

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.

Autore in primo piano: Un focus sul protocollo ecografico standardizzato delle ghiandole salivari nella ricerca sulle malattie del tessuto connettivo

Valutazione ecografica delle ghiandole salivari per la sindrome di Sjogren: approfondimenti diagnostici e di monitoraggio

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.

Impostazione ecografica e scansione della ghiandola tiroidea per l&#39;esame della sindrome di Sjogren

Per iniziare, selezionare un trasduttore lineare ad alta frequenza da 10 megahertz. Impostare l'ecografia in modalità B e utilizzare la frequenza più alta della sonda. Regolare la profondità a tre centimetri e guadagnare dal 50% al 60%Posizionare il paziente in posizione supina con il collo leggermente esteso, utilizzare un cuscino per sostenere la testa del paziente.Per le immagini trasversali, orientare la sonda con il marcatore rivolto verso il lato destro del paziente. Per la scansione longitudinale, orientare il marcatore sul lato cefalico. Applicare il gel sulla superficie della sonda.Posizionare la sonda sotto la cartilagine tiroidea per scansionare la ghiandola tiroidea. Salva le immagini ottenute. Collega i lobi destro e sinistro della ghiandola tiroidea.Considera come riferimento l'ecogenicità di una normale ghiandola tiroidea. Per qualsiasi malattia tiroidea concomitante, confrontare l'ecogenicità con quella dei muscoli circostanti.

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 ...

Ricerca

Medicina

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

Ecografia della ghiandola parotide per l&#39;esame della sindrome di Sjogren

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

Ecografia della ghiandola sottomandibolare per l&#39;esame della sindrome di Sjogren