The applicability of ultrasound in the diagnosis of inflammatory and obstructive diseases of the major salivary glands: a scoping review

Pivotal Role of Ultrasonography and Radiology in Diagnosing a Case of Sialolith

Sialolithiasis is a condition that affects the salivary glands, which commonly occurs within the body of the submandibular gland or the Wharton duct. This condition is characterised by pain in the submandibular area after meals. Conservative therapies such as duct milking and palliative care can provide positive results for small, easily accessible calculi. This report describes the results of radiographic imaging of a 43-year-old patient with pain and swelling in the submandibular region. During the extraoral examination, a 1.5 cm wide diffuse swelling was present in the left submandibular region, and the left submandibular gland was tender and firm. In addition, a solitary, tender left submandibular lymph node was observed. Intraorally, the opening of the submandibular duct was erythematous and inflamed. The patient was advised for necessary investigations, including an orthopantomogram, cone beam CT, neck ultrasound, and left submandibular gland sialography. Ultrasonography was preferred over other imaging techniques due to its non-invasive nature and high accuracy, sensitivity, and specificity in diagnosing sialolithiasis. Timely management of sialolith is critical as delayed treatment can lead to serious consequences. A conclusive diagnosis of left submandibular sialolithiasis, accompanied by sialadenitis, was made based on clinical, radiographic, and ultrasound findings.

Overview of Ultrasound in Dentistry for Advancing Research Methodology and Patient Care Quality with Emphasis on Periodontal/Peri-implant Applications

BACKGROUND

Ultrasound is a non-invasive, cross-sectional imaging technique emerging in dentistry. It is an adjunct tool for diagnosing pathologies in the oral cavity that overcomes some limitations of current methodologies, including direct clinical examination, 2D radiographs, and cone beam computerized tomography. Increasing demand for soft tissue imaging has led to continuous improvements on transducer miniaturization and spatial resolution. The aims of this study are (1) to create a comprehensive overview of the current literature of ultrasonic imaging relating to dentistry, and (2) to provide a view onto investigations with immediate, intermediate, and long-term impact in periodontology and implantology.

METHODS

A rapid literature review was performed using two broad searches conducted in the PubMed database, yielding 576 and 757 citations, respectively. A rating was established within a citation software (EndNote) using a 5-star classification. The broad search with 757 citations allowed for high sensitivity whereas the subsequent rating added specificity.

RESULTS

A critical review of the clinical applications of ultrasound in dentistry was provided with a focus on applications in periodontology and implantology. The role of ultrasound as a developing dental diagnostic tool was reviewed. Specific uses such as soft and hard tissue imaging, longitudinal monitoring, as well as anatomic and physiological evaluation were discussed.

CONCLUSIONS

Future efforts should be directed towards the transition of ultrasonography from a research tool to a clinical tool. Moreover, a dedicated effort is needed to introduce ultrasonic imaging to dental education and the dental community to ultimately improve the quality of patient care.

American College of Rheumatology and the European League Against Rheumatism classification criteria for IgG4-related disease: an update for radiologists

IgG4-related disease (IgG4-RD) is an immune-mediated, multiorgan, chronic inflammatory disease. The three-step classification criteria proposed in 2019 by the American College of Rheumatology and the European League Against Rheumatism (ACR/EULAR) encompass a wide range of clinical, radiological, serological, and histopathological findings. The ACR/EULAR proposed a three-step classification process, i.e., entry step, exclusion step, and scoring system. Radiologists need to know that the radiological findings observed in the five domains of the lacrimal and salivary glands, chest, pancreas and biliary ducts, kidney, and retroperitoneum are independently weighted with different points in the scoring system. A total score < 20 points indicates that the patient should not be classified as having IgG4-RD; conversely, a total score ≥ 20 points indicates that the patient should be classified as having IgG4-RD. In this review, the 2019 ACR/EULAR classification criteria are discussed, focusing on the interpretation of each radiological item, with the aim of applying them to the diagnosis of IgG4-RD in clinical practice.