Morphological diagnostics of Sjogren's syndrome. Is salivary gland biopsy imperative?

Despite Sjogren's syndrome becoming recognized as a common autoimmune disease a specific diagnostic marker is not available. Increasing awareness and improved diagnostic tests did not result in the same criteria in different countries. For many years minor salivary gland biopsy was considered to be the essential diagnostic measure. Current improvements of other tests using immunological and radiological methods allow to diagnose Sjogren's syndrome by findings other than those acquired by histopathology. Immunology and magnetic resonance imaging are of great value. Magnetic resonance imaging of the parotid gland in particular provides an alternative tool to assess salivary gland involvement.