Clinical Rheumatology最新文献

{"title":"Is there an additional benefit of ultrasound-guided coracohumeral ligament hydrorelease in cases with primary adhesive capsulitis undergoing ultrasound-guided shoulder hydrodilatation?","authors":"Sibel Suzen Ozbayrak, Elem Yorulmaz, Duygu Geler Kulcu","doi":"10.1007/s10067-025-07677-5","DOIUrl":"https://doi.org/10.1007/s10067-025-07677-5","url":null,"abstract":"<p><strong>Objective: </strong>Primary adhesive capsulitis (AC) of the shoulder is a chronic, painful condition characterized by progressive restriction of shoulder range of motion. While conservative management remains the first-line treatment, its efficacy is sometimes limited, prompting exploration of adjunctive interventions. Recent studies have highlighted the effectiveness of hydrorelease of the coracohumeral ligament (CHL) in improving shoulder mobility. This study aimed to evaluate whether ultrasound-guided hydrorelease of the CHL confers additional clinical benefit in patients with shoulder AC undergoing ultrasound-guided hydrodilatation.</p><p><strong>Methods: </strong>Patients diagnosed with primary AC were randomly assigned to one of two groups. Group 1 received both ultrasound-guided hydrodilatation and CHL hydrorelease, while Group 2 received ultrasound-guided hydrodilatation alone. Clinical evaluations were conducted at baseline, immediately post-injection, and at 1 week, 1 month, and 3 months post-injection. Outcome measures included the Visual Analog Scale (VAS) for pain, shoulder range of motion (ROM) (including flexion, abduction, internal rotation, and external rotation), and the Shoulder Disability Index (SDI).</p><p><strong>Results: </strong>Both groups demonstrated significant improvements from baseline in pain intensity, shoulder ROM and SDI scores at all follow-up time points. However, no statistically significant differences were observed between the two groups regarding the magnitude of improvement in any of the evaluated parameters.</p><p><strong>Conclusion: </strong>Ultrasound-guided hydrodilatation is effective in reducing pain, improving shoulder range of motion and function in patients with primary AC. However, the addition of CHL hydrorelease does not appear to provide further benefit in terms of pain relief, range of motion, or functional outcomes. Key Points •Ultrasound-guided hydrodilatation therapy is an effective treatment choice for primary adhesive capsulitis of the shoulder. •Patients receiving hydrodilatation treatment do not benefit further from applying hydrorelease to the coracohumeral ligament.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to a letter to the editor entitled \"CMV Reactivation in RMDs: Are We Capturing the Full Picture?\" by You et al.","authors":"Yuichiro Ota, Masaru Takeshita, Yasushi Kondo, Shuntaro Saito, Jun Kikuchi, Hironari Hanaoka, Tsutomu Takeuchi, Yuko Kaneko","doi":"10.1007/s10067-025-07690-8","DOIUrl":"https://doi.org/10.1007/s10067-025-07690-8","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding spiritual well-being in patients with systemic sclerosis and its effect on the illness: a scoping review.","authors":"Stella Gkountinaki, Foula Protopapa, Amit Syal, Andreas Chatzittofis, Konstantinos Parperis, Chris T Derk","doi":"10.1007/s10067-025-07689-1","DOIUrl":"https://doi.org/10.1007/s10067-025-07689-1","url":null,"abstract":"<p><strong>Background: </strong>Spirituality has become an increasingly important domain of care in chronic diseases, yet little is known about its impact in systemic sclerosis (SSc), a rare autoimmune condition associated with high psychosocial burden. Understanding the spiritual well-being of these patients may offer important insights into coping, quality of life, and patient-centered interventions.</p><p><strong>Methods: </strong>This scoping review followed PRISMA guidelines and included a comprehensive search of five databases for studies addressing spirituality in patients with SSc. We extracted demographic and methodological details from each study and assessed quality using the Joanna Briggs Institute (JBI) criteria.</p><p><strong>Results: </strong>Ten studies met inclusion criteria. Spirituality was frequently associated with improved psychological outcomes, including reduced depression and anxiety, increased life satisfaction, and greater resilience. Instruments used to assess spirituality included FACIT-Sp, MI-RSWB, and STS, among others. However, heterogeneity in methodology and limited focus on SSc-specific populations remain notable.</p><p><strong>Conclusion: </strong>Spiritual well-being plays a significant role in the lived experience of patients with SSc. Future studies should standardize measurement tools and examine culturally sensitive, spirituality-integrated interventions. Incorporating spiritual assessment into rheumatologic care may enhance patient outcomes. Key Points •Spiritual well-being is increasingly recognized as a critical domain of health in patients with chronic illnesses, including systemic sclerosis. •Spirituality is a relevant and influential factor in the lived experience of SSc. It affects not only how patients understand and cope with their illness but also how they engage with healthcare systems. •Spirituality was frequently associated with improved psychological outcomes, including reduced depression and anxiety, increased life satisfaction, and greater resilience.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations among ankle cartilage composition and ultrasound based measures of cartilage health in those with chronic ankle instability.","authors":"Erik A Wikstrom, Jaeho Jang, Brian Pietrosimone, Jason R Franz, Daniel B Nissman, Feng-Chang Lin","doi":"10.1007/s10067-025-07680-w","DOIUrl":"https://doi.org/10.1007/s10067-025-07680-w","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Chronic ankle instability (CAI) is a significant contributor to articular degeneration at the ankle. Identifying early pathogenic articular changes is limited to compositional MRI techniques which are not clinically feasible. Ultrasound is cost-effective, and echo-intensity (EI) measures may be an indicator of cartilage health. Therefore, we aimed to (i) quantify changes in ultrasound measures of talar cross-sectional area (CSA) and EI following standardized loading protocols and recovery periods and (ii) quantify the associations between ultrasound measures and talar and subtalar cartilage composition in those with CAI.</p><p><strong>Method: </strong>Thirty-seven individuals with CAI (22.6 ± 4.2 years, 3.8 ± 2.7 sprains) completed a T1ρ MRI and two ultrasound assessments. The talar cartilage was imaged with US before, immediately after, 15-min after, and 30-min after separate static and dynamic loading protocols.</p><p><strong>Results: </strong>Ultrasound outcomes acutely changed in response to load (p < 0.05). The CSA and EI means remained altered throughout the recovery period (p < 0.05) while the EI standard deviation recovered to baseline levels. Greater subtalar T1ρ relaxation times (i.e., worse composition) were significantly (p ≤ 0.05) associated with lower thickness (r = -0.409) and EI variability (r = 0.419) baseline values, greater EI mean responses to load (r = -0.558), and smaller EI mean recoveries (r ≥ -0.360) which all suggest worse cartilage health.</p><p><strong>Conclusions: </strong>In those with CAI, ultrasound-based outcomes acutely respond to load but have unique recovery patterns. Ultrasound may serve as a valid clinically accessible tool to evaluate ankle cartilage composition, particularly Subtalar cartilage. Key Points • In those with CAI, talar cartilage CSA and EI, measured via ultrasound, are acutely sensitive to load but recovery patterns are outcome specific. • Ultrasound measures of thickness and EI may serve as valid clinically accessible surrogates of subtalar cartilage composition.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of shared diagnostic biomarkers and potential co-morbidity mechanisms between primary Sjogren's syndrome and chronic kidney disease.","authors":"Shushu Jiang, Yin Dong, Zhaohui Wang, Minglu Liang","doi":"10.1007/s10067-025-07623-5","DOIUrl":"https://doi.org/10.1007/s10067-025-07623-5","url":null,"abstract":"<p><strong>Background: </strong>The mechanisms linking primary Sjogren's syndrome (pSS) to chronic kidney disease (CKD) are obscure. Our study sought to uncover shared genetic connections and pathways between these conditions.</p><p><strong>Methods: </strong>Datasets for pSS and CKD were sourced from GEO. WGCNA alongside differential expression assessment was employed to pinpoint common genes. GO and KEGG were applied for gene enrichment. Key genes were selected using LASSO, Random Forest, and SVM-RFE. Clinical prediction models were constructed using multi-factor logistic regression. GSEA and immune infiltration analyses explored the mechanisms linking key genes in pSS and CKD. MR analysis and SMR approach assessed the genetic link between pSS and CKD, evaluating the impact of co-shared genes on these conditions.</p><p><strong>Result: </strong>We identified 104 common genes using WGCNA and differential expression analysis. GO and KEGG analyses hinted at cancer involvement in both diseases. Machine learning models pinpointed five genes as strong diagnostic biomarkers for both pSS and CKD, with NUDT1 and COMMD2 validated in independent cohorts. Clinical prediction models were constructed based on these two genes. GSEA and immune infiltration analysis suggested immune processes, particularly T cell infiltration, were implicated in both diseases. Bidirectional MR analysis failed to establish a causal link between the two diseases, yet SMR analysis revealed associations between NUDT1 and COMMD2 expression and the development of pSS and CKD.</p><p><strong>Conclusion: </strong>This study uncovered crucial genes shared between pSS and CKD, shedding light on their co-morbidity mechanisms and possible diagnostic biomarkers. Key Points • This study unveils for the first time the immunological association between PSS and CKD. • NUDT1 and COMMD2 are identified as key molecules in the comorbidity mechanism of PSS and CKD. • A diagnostic model for the comorbidity of PSS and CKD is constructed.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between immunoglobulin G N-glycosylation, inflammatory factors, and ankylosing spondylitis: A case-control study.","authors":"Jia Yin, Xuan Yin, Lei Tao, Yuanzhi Peng, Shuhan Zhao, Haifeng Hou, Xinyue Yin, Zhangshen Ran, Aihong Zhou, Guoyong Ding","doi":"10.1007/s10067-025-07639-x","DOIUrl":"https://doi.org/10.1007/s10067-025-07639-x","url":null,"abstract":"<p><strong>Background: </strong>Alterations in immunoglobulin G (IgG) N-glycosylation have been implicated in various diseases, potentially including ankylosing spondylitis (AS). However, empirical evidence regarding the associations IgG N-glycosylation, inflammatory factors, and AS is sparse. We aimed to investigate these associations and evaluate the diagnostic performance of IgG glycosylation traits as a biomarker for AS.</p><p><strong>Methods: </strong>This case-control study recruited 142 AS patients and 142 controls. We used hydrophilic interaction liquid chromatography with ultra-performance liquid chromatography to detect the profiles of plasma IgG N-glycans. An enzyme-linked immunosorbent assay kit was used to measure the levels of serum inflammatory factors. We used multivariate logistic regression, canonical correlation analysis (CCA), and Lasso regression to analyze the data.</p><p><strong>Results: </strong>Multivariate logistic analysis identified 14 IgG N-glycan-derived traits significantly associated with AS. The changes were primarily characterized by decreased galactosylation, sialylation, bisgalactosylated fucosylation and sialated fucosylation, alongside increased core fucosylation, agalactosylated fucosylation, neutral fucosylation and sialated bisecting N-acetylglucosamine. Significant differences were observed between cases and controls in levels of C-reactive protein (CRP), IL-17, IL-22, IL-6, and TNF-α. CCA demonstrated a moderate correlation between IgG N-glycan-derived traits and inflammatory factors (r = 0.476). The combined diagnostic performance of derived traits and inflammatory factors yielded a higher area under the curve (AUC = 0.90) than either alone (AUC_{derived traits} = 0.88, AUC_{inflammatory factors} = 0.78).</p><p><strong>Conclusion: </strong>The findings indicate that abnormal IgG N-glycosylation may play an important role in the development of AS through promoting the pro-inflammatory function. The derived traits combined with inflammatory factors may serve as potential biomarkers to distinguish AS. Key Points • We comprehensively analyzed IgG N-glycan-derived traits in AS by an HILIC-UPLC-based high-throughput method. • Abnormal IgG N-glycosylation plays a role in the development of AS through promoting the proinflammatory. • IgG N-glycosylation combined with inflammatory factors demonstrated strong diagnostic performance for AS.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of large language models in delivering guideline-compliant recommendations for topical NSAID use in musculoskeletal pain: a multidimensional analysis.","authors":"Chengqi Dong, Xu Qiu, Jiayi Deng, Li Xu, Xiaoxue Dong, Shi Chen, Tao Mei, Qinghua Li, Yuan Cheng, Jianliang Sun, Hanbin Wang, Liang Yu","doi":"10.1007/s10067-025-07640-4","DOIUrl":"https://doi.org/10.1007/s10067-025-07640-4","url":null,"abstract":"<p><strong>Introduction: </strong>While large language models (LLMs) are increasingly used in clinical decision support, their adherence to evidence-based guidelines-particularly for musculoskeletal pain management-remains understudied.</p><p><strong>Methods: </strong>Four LLMs (DeepSeek-R1, ChatGPT-4o, Gemini, Grok-3) were evaluated on their responses to topical NSAID use for musculoskeletal pain through: assessments of response quality (accuracy, over-conclusiveness, supplementary information, and incompleteness), standardized readability metrics (Flesch Reading Ease, Flesch-Kincaid Grade Level), and the PEMAT-P tool to quantify actionability.</p><p><strong>Results: </strong>The four LLMs showed significant variability in accuracy (ANOVA p = 0.045), with Gemini scoring highest (8.33 ± 0.77) and DeepSeek-R1 lowest (7.72 ± 1.52) and in over-conclusiveness (ANOVA p = 0.025), with Grok-3 scoring lowest (4.56 ± 1.42) and ChatGPT-4o highest 6.72 ± 1.49). ChatGPT-4o provided the most supplementary content (6.94 ± 2.29, p = 0.106) and DeepSeek-R1 had the highest incompleteness (5.00 ± 2.52, p = 0.261). All models exceeded recommended readability thresholds (9th-10th grade level), and none met the actionability standard (≤ 33.5%).</p><p><strong>Conclusions: </strong>LLMs demonstrate potential as clinical aids. The comprehensive performance of Gemini and Grok is relatively favorable, yet their readability and actionability remain unsatisfactory. Future development should integrate clinician feedback and real-world validation to ensure safety. Human oversight and targeted AI training are critical for safe implementation. Key Points • The study reveals significant differences in accuracy among LLMs, highlighting inconsistencies in clinical decision support. • While all models generated readable text, the complexity remained high, potentially limiting accessibility for some patients. • Glucocorticoid use for patients in remission was more strongly associated with impaired physical function in patients aged 75-84 than in patients aged 55-74 years. • Over-conclusiveness and incomplete adherence to evidence-based guidelines underscore the necessity for human oversight and targeted AI training in clinical applications.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple comorbidities and economic burden of hospitalized gout patients in Guangdong Province.","authors":"Jie Ren, Xuantao Yan, Shan Zeng, Jiajing Wu, Siman Cao, Yangxing Luo, Wenhao Zhang, Wei Hu, Xiaoliang Huang, Yi Zhou","doi":"10.1007/s10067-025-07603-9","DOIUrl":"https://doi.org/10.1007/s10067-025-07603-9","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to analyze the prevalence of multiple comorbidities and economic burden of hospitalized patients with gout in Guangdong Province.</p><p><strong>Methods: </strong>We retrieved the homepage information of 593,792 hospitalized patients with gout from January 1, 2015 to December 31, 2021 through the Guangdong Provincial Medical Record Homepage System and analyzed the prevalence of single comorbidity and multiple comorbidities and economic burden.</p><p><strong>Results: </strong>1. The prevalence of gout was 1.31%. The prevalence in males was five times higher than that of females. 2. The prevalence of hypertension was highest (42.59%) in gout patients; the following were type 2 diabetes (18.03%) and hyperlipidemia (17.98%). 3. The prevalence of hypertension, hyperlipidemia, type 2 diabetes, chronic heart failure, coronary heart disease, and chronic kidney disease were more prevalent in women (P < 0.05). 4. Gout-hypertension-type 2 diabetes had the highest prevalence in all gout patients. The prevalence of multiple complications showed an increasing trend. 5. Gout- hypertension-type 2 diabetes had the highest prevalence in male and female patients (P < 0.001). Except for the prevalence of gout-hypertension-obesity, gout-obesity-type 2 diabetes and gout-hypertension-obesity-type 2 diabetes, the prevalence of other multiple comorbidities was significantly higher in women (P < 0.001). 6. The average annual cost of hospitalized patients with acute gouty arthritis ranged from RMB 5994.45 to RMB 6709.66, which decreased in women. From 2020 to 2021, the average cost of men with acute gout was much higher than that of women. From 2018 to 2021, the average cost was highest in patients among 40-69 years old.</p><p><strong>Conclusions: </strong>1. Gout patients often have single and multiple comorbidities with a higher prevalence in women, and the prevalence showed an increasing trend. 2. Acute gout patients had high hospital costs, and female patients showed a downward trend. Key points • Gout patients have increasing single and multiple comorbidities with a higher prevalence in women. • Acute gout patients had high hospital costs, and female patients showed a downward trend.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Andersson lesions in ankylosing spondylitis.","authors":"Raktim Swarnakar","doi":"10.1007/s10067-025-07694-4","DOIUrl":"https://doi.org/10.1007/s10067-025-07694-4","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agreement between glandular ultrasonography and histopathology of minor salivary glands in adults with sicca syndrome.","authors":"José S Cortés, Wilder Carvajal, Alejandro Correa, Karen Veloza, Eybar Díaz, Luis J Cajas","doi":"10.1007/s10067-025-07650-2","DOIUrl":"https://doi.org/10.1007/s10067-025-07650-2","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Sjögren's disease is an autoimmune disease that primarily affects the exocrine glands. Agreement between glandular ultrasound and focus score has been described as moderate to strong. The objective of this study was to assess the agreement between ultrasound findings of salivary and lacrimal glands and the histopathological results of minor salivary gland biopsies in patients with sicca syndrome seen at a quaternary care hospital in Colombia.</p><p><strong>Methods: </strong>This was an ambispective cohort study. A total of 66 patients were included, of whom 42 were classified as having Sjögren's disease and 24 as having non-Sjögren sicca syndrome, according to the 2016 ACR/EULAR classification criteria. Focus scores were obtained from minor salivary gland biopsy reports, and ultrasound of the lacrimal and salivary glands was performed.</p><p><strong>Results: </strong>Ultrasound findings showed that 57.6% of patients presented glandular abnormalities, most frequently in the submandibular glands. The agreement between ultrasound findings and minor salivary gland biopsy was low (agreement rate: 57%, Kappa: 0.178). Advanced age (> 68 years) was identified as a factor negatively influencing the agreement. Parotid gland ultrasound had high specificity (100%) for the diagnosis of Sjögren's disease, but limited sensitivity (24-30%). No significant association was found between abnormalities in lacrimal glands and the diagnosis of Sjögren's disease.</p><p><strong>Conclusion: </strong>Although glandular ultrasound may serve as a complementary tool, it cannot yet replace minor salivary gland biopsy for the diagnosis of Sjögren's disease. Further studies are needed to confirm its diagnostic performance and agreement with salivary gland histopathology. Key Points • Overall agreement between ultrasound and minor salivary gland biopsy was low in this cohort • Older age (>68 years) was associated with reduced agreement between imaging and histopathology • Parotid gland ultrasound showed high specificity but limited sensitivity for classifying Sjögren's disease.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}