Diagnostic Utility of Ultrasound in the Management of Patients with Juvenile Recurrent Parotitis on Conservative Therapy

Bibin Sebastian, Tom George and Richard Thomas



Introduction: The purpose of this study is to evaluate the utility of ultrasound in patients with Juvenile Recurrent Parotitis (JRP) on conservative treatment.
Methods: This prospective study included 22 patients who were referred for ultrasound with an initial clinical diagnosis of JRP. Ultrasound findings were scored as Type 1 – consistent with JRP, Type 2 – indeterminate for JRP and Type 3 – no features of JRP. The medical records of these patients were followed up for a period of 2 years from the time of first scan to record the final diagnosis, number of recurrent episodes and need for additional radiological investigations or sialoendoscopy.
Results: The final clinical diagnosis was JRP in 14 patients, intra-parotid lymphadenopathy in 6 patients and Sjogren’s syndrome in 2 patients. Ultrasound showed type 1 findings in 10/14 (71%) and type 2 findings in 4/14 (29%) patients with JRP. 12 patients with JRP remained on conservative therapy at the end of the follow up period of 2 years. 2 patients with JRP had insufficient control of symptoms and were referred to an outside institute for sialoendoscopy. 8 patients with JRP (57%) had unilateral involvement. Mean number of annual recurrent episodes was 2. During the recurrent episodes, ultrasound demonstrated similar findings as seen during initial presentation.
Discussion: In majority of patients with JRP, ultrasound can demonstrate characteristic imaging findings. While the ultrasound findings of JRP can overlap with Sjogren’s syndrome, these two entities can be differentiated based on clinical presentation and presence of positive serological markers in the latter. Unilateral involvement can differentiate JRP from other entities such as intra-parotid lymphadenopathy and Sjogren’s syndrome.
Conclusion: Ultrasound, when combined with clinical information can help establish a definitive diagnosis of JRP and can obviate the need for other radiological investigations in patients on conservative therapy.

Published on: April 09, 2020
doi: 10.17756/micr.2020-039
Citation: Sebastian B, George T, Thomas R. 2020. Diagnostic Utility of Ultrasound in the Management of Patients with Juvenile Recurrent Parotitis on Conservative Therapy. J Med Imaging Case Rep 4(1): 9-12.