Imaging can be helpful when investigating salivary gland pain and swelling. Typically in such cases, an ultrasound (US) or conventional sialogram would be requested in seeking obstructed or dilated ducts, a ductal calculus or an abscess within the gland. Occasionally a CT scan is requested. MR is usually reserved for investigating clinically palpable masses in the glands.

In acute non-obstructive parotitis, the differential diagnosis includes acute non-suppurative parotitis (as found in mumps), early Sjögren’s syndrome, or suppurative parotitis as seen following duct obstruction. Despite sometimes strong insistence on retrograde contrast sialography, this may exacerbate the pre-existing inflammatory process. The imaging of a young patient expands on these observations.

MRI: Sjogrens Syndrome:MRI Sialogram