Diagnostic value of high-frequency ultrasound assessment of the lacrimal glands for primary Sjögren’s disease

Objectives The aim of the study was to evaluate the ultrasound findings in lacrimal glands in a cohort of patients with suspected primary Sjögren’s disease (pSjD) and to assess the relationship with the diagnosis and the association with functional tests and autoantibodies.Methods Patients with susp...

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Main Authors: Lene Terslev, Mads Ammitzbøll-Danielsen, Viktoria Fana, Nanna Surlemont Schmidt
Format: Article
Language:English
Published: BMJ Publishing Group 2025-07-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/11/3/e005884.full
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author Lene Terslev
Mads Ammitzbøll-Danielsen
Viktoria Fana
Nanna Surlemont Schmidt
author_facet Lene Terslev
Mads Ammitzbøll-Danielsen
Viktoria Fana
Nanna Surlemont Schmidt
author_sort Lene Terslev
collection DOAJ
description Objectives The aim of the study was to evaluate the ultrasound findings in lacrimal glands in a cohort of patients with suspected primary Sjögren’s disease (pSjD) and to assess the relationship with the diagnosis and the association with functional tests and autoantibodies.Methods Patients with suspected pSjD, evaluated by salivary gland ultrasound (SGUS) and lacrimal gland (LGUS) as part of the diagnostic set-up were included. All had unstimulated sialometry, Schirmer’s test and laboratory test done (including autoantibodies). Ultrasound examination was performed with a GE Logiq E10 (a linear 4–20 MHz transducer for SGUS and a 6–24 MHz hockey stick transducer for LGUS). The OMERACT consensus-based greyscale scoring system (0–3) for salivary glands was applied for all glands. A score of ≥2 was considered pathological.Results 30 patients were included, one was subsequently excluded due to missing data, 13 were diagnosed with pSjD according to the American College of Rheumatology/EULAR classification criteria. The sensitivity and specificity for LGUS for pSJD diagnosis were 61.5 and 87.5, respectively. The PPV and NPV values were 80.0 and 73.3, respectively—better than SGUS for the current cohort. There was no statistically significant association between LGUS and Schirmer’s test positivity (p value: 0.86), but there was a significant association between LGUS and SSA (OR: 17.4, p=0.005) as well as SSB (OR: 23.0, p=0.003).Conclusion LGUS has moderate sensitivity and high specificity for the diagnosis of pSjD. The OMERACT scoring system appears relevant for scoring pathology in the lacrimal glands using grade ≥2 as cut-off and may be a valuable supplementary tool for diagnostic evaluation in pSjD.
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spelling doaj-art-8fa5238b3c554102abc75da630ec6ff02025-08-20T03:40:52ZengBMJ Publishing GroupRMD Open2056-59332025-07-0111310.1136/rmdopen-2025-005884Diagnostic value of high-frequency ultrasound assessment of the lacrimal glands for primary Sjögren’s diseaseLene Terslev0Mads Ammitzbøll-Danielsen1Viktoria Fana2Nanna Surlemont Schmidt3Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, Glostrup, DenmarkCenter for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, Glostrup, DenmarkCenter for Rheuamtology and Spine Diseases, Rigshospitalet, VHV, Copenhagen, DenmarkCenter for Rheuamtology and Spine Diseases, Rigshospitalet, VHV, Copenhagen, DenmarkObjectives The aim of the study was to evaluate the ultrasound findings in lacrimal glands in a cohort of patients with suspected primary Sjögren’s disease (pSjD) and to assess the relationship with the diagnosis and the association with functional tests and autoantibodies.Methods Patients with suspected pSjD, evaluated by salivary gland ultrasound (SGUS) and lacrimal gland (LGUS) as part of the diagnostic set-up were included. All had unstimulated sialometry, Schirmer’s test and laboratory test done (including autoantibodies). Ultrasound examination was performed with a GE Logiq E10 (a linear 4–20 MHz transducer for SGUS and a 6–24 MHz hockey stick transducer for LGUS). The OMERACT consensus-based greyscale scoring system (0–3) for salivary glands was applied for all glands. A score of ≥2 was considered pathological.Results 30 patients were included, one was subsequently excluded due to missing data, 13 were diagnosed with pSjD according to the American College of Rheumatology/EULAR classification criteria. The sensitivity and specificity for LGUS for pSJD diagnosis were 61.5 and 87.5, respectively. The PPV and NPV values were 80.0 and 73.3, respectively—better than SGUS for the current cohort. There was no statistically significant association between LGUS and Schirmer’s test positivity (p value: 0.86), but there was a significant association between LGUS and SSA (OR: 17.4, p=0.005) as well as SSB (OR: 23.0, p=0.003).Conclusion LGUS has moderate sensitivity and high specificity for the diagnosis of pSjD. The OMERACT scoring system appears relevant for scoring pathology in the lacrimal glands using grade ≥2 as cut-off and may be a valuable supplementary tool for diagnostic evaluation in pSjD.https://rmdopen.bmj.com/content/11/3/e005884.full
spellingShingle Lene Terslev
Mads Ammitzbøll-Danielsen
Viktoria Fana
Nanna Surlemont Schmidt
Diagnostic value of high-frequency ultrasound assessment of the lacrimal glands for primary Sjögren’s disease
RMD Open
title Diagnostic value of high-frequency ultrasound assessment of the lacrimal glands for primary Sjögren’s disease
title_full Diagnostic value of high-frequency ultrasound assessment of the lacrimal glands for primary Sjögren’s disease
title_fullStr Diagnostic value of high-frequency ultrasound assessment of the lacrimal glands for primary Sjögren’s disease
title_full_unstemmed Diagnostic value of high-frequency ultrasound assessment of the lacrimal glands for primary Sjögren’s disease
title_short Diagnostic value of high-frequency ultrasound assessment of the lacrimal glands for primary Sjögren’s disease
title_sort diagnostic value of high frequency ultrasound assessment of the lacrimal glands for primary sjogren s disease
url https://rmdopen.bmj.com/content/11/3/e005884.full
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