Sialolithiasis diagnostic study of choice: Difference between revisions

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__NOTOC__
__NOTOC__
{{Sialolithiasis}}
{{Sialolithiasis}}
{{CMG}}; {{AE}}
{{CMG}}; {{AE}}{{MA}} [mailto:malihash@bidmc.harvard.edu]
== Overview ==
== Overview ==
Sialolithiasis is mainly diagnosed by history and physical examination. Diagnosis can be confirmed by [[computed tomography]], [[ultrasound]], magnetic resonance sialography, conventional [[sialography]]. [[High Resolution CT|High resolution computed tomography]] ([[High Resolution CT|HRCT]]) scanning is the study of choice for the diagnosis of sialolithisis.


== Diagnostic Study of Choice ==
== Diagnostic Study of Choice ==
Sialolithiasis is mainly diagnosed by history and physical examination. Diagnosis can be confirmed by [[computed tomography]], [[ultrasound]], magnetic resonance sialography, conventional [[sialography]].


===== Template statements =====
=== Study of choice: ===
 
===== Computed tomography =====
*  [[High Resolution CT|High resolution computed tomography]] ([[High Resolution CT|HRCT]]) scanning is the study of choice for the diagnosis of sialolithiasis.<ref name="ElliesLaskawi1996">{{cite journal|last1=Ellies|first1=Maik|last2=Laskawi|first2=Rainer|last3=Arglebe|first3=Christian|last4=Schott|first4=Anngrit|title=Surgical management of nonneoplastic diseases of the submandibular gland|journal=International Journal of Oral and Maxillofacial Surgery|volume=25|issue=4|year=1996|pages=285–289|issn=09015027|doi=10.1016/S0901-5027(06)80058-5}}</ref>
** Most stones contain enough [[calcium]], so they can be visible with non-contrast [[Computed tomography|CT scan]].
 
* The following results are seen in acute obstructive due to sialolithiasis after administration of contrast:
** The gland may appear enlarged
** Hyperdensity of gland with stranding


=== Study of choice: ===
* In chronic sialolithiasis, fatty atrophy and reduction in salivary gland parenchymal volume may be seen.
* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
* The following result of [gold standard test] is confirmatory of [disease name]:
** Result 1
** Result 2
* The [name of the investigation] should be performed when:
** The patient presented with symptoms/signs 1. 2, 3.
** A positive [test] is detected in the patient.
* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
* The diagnostic study of choice for [disease name] is [name of the investigation].
* There is no single diagnostic study of choice for the diagnosis of [disease name].
* There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
* [Disease name] is mainly diagnosed based on clinical presentation.
* Investigations:
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.


==== The comparison table for diagnostic studies of choice for [disease name] ====
==== The comparison table for diagnostic studies of choice for sialolithiasis ====
The [[Sensitivity (tests)|sensitivity]] and [[Specificity (tests)|specificity]] of CT scan and [[ultrasonography]] in a patient with sialolitiasis is given below:<ref name="pmid28457224">{{cite journal |vauthors=Thomas WW, Douglas JE, Rassekh CH |title=Accuracy of Ultrasonography and Computed Tomography in the Evaluation of Patients Undergoing Sialendoscopy for Sialolithiasis |journal=Otolaryngol Head Neck Surg |volume=156 |issue=5 |pages=834–839 |year=2017 |pmid=28457224 |doi=10.1177/0194599817696308 |url=}}</ref>
{|
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! style="background: #FFFFFF; color: #FFFFFF; text-align: center;" |
! style="background: #FFFFFF; color: #FFFFFF; text-align: center;" |Method
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
|-
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 1
! style="background: #696969; color: #FFFFFF; text-align: center;" |CT scan
| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
| style="background: #DCDCDC; padding: 5px; text-align: center;" |98%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |88%
|-
|-
! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 2
! style="background: #696969; color: #FFFFFF; text-align: center;" |Ultrasound
| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |65%
| style="background: #DCDCDC; padding: 5px; text-align: center;" |✔
| style="background: #DCDCDC; padding: 5px; text-align: center;" |80%
|}
|}
<small> ✔= The best test based on the feature </small>
===== Diagnostic results =====
The following result of [investigation name] is confirmatory of [disease name]:
* Result 1
* Result 2
===== Sequence of Diagnostic Studies =====
The [name of investigation] should be performed when:
* The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
* A positive [test] is detected in the patient, to confirm the diagnosis.
=== Diagnostic Criteria ===
* Here you should describe the details of the diagnostic criteria.
*Always mention the name of the criteria/definition you are about to list (e.g. modified Duke criteria for the diagnosis of endocarditis / 3rd universal definition of MI) and cite the primary source of where this criteria/definition is found.
*Although not necessary, it is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.
*Be very clear as to the number of criteria (or threshold) that needs to be met out of the total number of criteria.
*Distinguish criteria based on their nature (e.g. clinical criteria / pathological criteria/ imaging criteria) before discussing them in details.
*To view an example (endocarditis diagnostic criteria), click [[Endocarditis diagnosis|here]]
*If relevant, add additional information that might help the reader distinguish various criteria or the evolution of criteria (e.g. original criteria vs. modified criteria).
*You may also add information about the sensitivity and specificity of the criteria, the pre-test probability, and other figures that may help the reader understand how valuable the criteria are clinically.
* [Disease name] is mainly diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
* There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
* The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
* The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
* [Disease name] may be diagnosed at any time if one or more of the following criteria are met:
** Criteria 1
** Criteria 2
** Criteria 3
IF there are clear, established diagnostic criteria:
*The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
*The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
*The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
IF there are no established diagnostic criteria: 
*There are no established criteria for the diagnosis of [disease name].


==References==
==References==
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[Category:Medicine]]
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[[Category:Gastroenterology]]
[[Category:Up-To-Date]]

Latest revision as of 00:10, 30 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2] [3]

Overview

Sialolithiasis is mainly diagnosed by history and physical examination. Diagnosis can be confirmed by computed tomography, ultrasound, magnetic resonance sialography, conventional sialography. High resolution computed tomography (HRCT) scanning is the study of choice for the diagnosis of sialolithisis.

Diagnostic Study of Choice

Sialolithiasis is mainly diagnosed by history and physical examination. Diagnosis can be confirmed by computed tomography, ultrasound, magnetic resonance sialography, conventional sialography.

Study of choice:

Computed tomography
  • The following results are seen in acute obstructive due to sialolithiasis after administration of contrast:
    • The gland may appear enlarged
    • Hyperdensity of gland with stranding
  • In chronic sialolithiasis, fatty atrophy and reduction in salivary gland parenchymal volume may be seen.

The comparison table for diagnostic studies of choice for sialolithiasis

The sensitivity and specificity of CT scan and ultrasonography in a patient with sialolitiasis is given below:[2]

Method Sensitivity Specificity
CT scan 98% 88%
Ultrasound 65% 80%

References

  1. ↑ Ellies, Maik; Laskawi, Rainer; Arglebe, Christian; Schott, Anngrit (1996). "Surgical management of nonneoplastic diseases of the submandibular gland". International Journal of Oral and Maxillofacial Surgery. 25 (4): 285–289. doi:10.1016/S0901-5027(06)80058-5. ISSN 0901-5027.
  2. ↑ Thomas WW, Douglas JE, Rassekh CH (2017). "Accuracy of Ultrasonography and Computed Tomography in the Evaluation of Patients Undergoing Sialendoscopy for Sialolithiasis". Otolaryngol Head Neck Surg. 156 (5): 834–839. doi:10.1177/0194599817696308. PMID 28457224.

Template:WH Template:WS [Category:Medicine]] ​​

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