# The Role of Imaging Techniques in the Evaluation of Extraglandular Manifestations in Patients with Sjögren’s Syndrome

## TL;DR

This review explores how imaging techniques help evaluate non-gland-related complications in Sjögren’s syndrome, improving early detection and monitoring.

## Contribution

The paper systematically reviews the specific roles of various imaging modalities in assessing multisystem involvement in Sjögren’s syndrome.

## Key findings

- Ultrasonography and elastography detect muscular and joint inflammation and tissue changes in Sjögren’s syndrome.
- High-resolution CT is most reliable for identifying interstitial lung disease in patients with the condition.
- MRI is effective in diagnosing neurological complications and lymphoproliferative disorders associated with Sjögren’s syndrome.

## Abstract

Sjögren’s syndrome is a chronic autoimmune disease marked by lymphocytic infiltration of the exocrine glands and the development of sicca symptoms, yet some patients also develop extraglandular involvement. Imaging has become relevant for describing these systemic features and supporting clinical assessment. This review discusses the roles of ultrasonography, elastography, computed tomography, and magnetic resonance imaging in evaluating multisystem disease associated with Sjögren’s syndrome. Ultrasonography and elastography help assess muscular involvement by showing changes in echogenicity and stiffness that reflect inflammation and later tissue remodeling. In joints, ultrasound can detect synovitis, tenosynovitis, and early erosive changes, including abnormalities not yet evident on examination. Pulmonary disease, most often with interstitial lung involvement, is best evaluated with high-resolution computed tomography, which remains the most reliable imaging modality for distinguishing interstitial patterns. Magnetic resonance imaging is valuable in assessing neurological complications. It can reveal ischemic and demyelinating lesions, neuromyelitis optica spectrum features, or pseudotumoral appearances. Imaging is also essential for detecting lymphoproliferative complications, for which ultrasound and magnetic resonance imaging can reveal characteristic structural and diffusion-weighted imaging findings. When combined with clinical and laboratory information, these imaging methods improve early recognition of systemic involvement and support accurate monitoring of disease progression in Sjögren’s syndrome.