What is the first-line investigation for salivary gland stone (sialolithiasis)?

The first-line investigation for salivary gland stones, or sialolithiasis, is an X-ray sialogram. This imaging technique is specifically designed to visualize the salivary ducts and glands, allowing for the detection of stones within these structures. The procedure involves injecting a contrast material into the duct of the affected gland, which then allows for enhanced visualization of the anatomy on X-ray images.

The use of a sialogram is particularly effective because it highlights the ductal system of the salivary glands, enabling the identification of any obstructions, such as stones, narrowing, or strictures. This specificity makes it the favored initial imaging choice for suspected sialolithiasis.

While computed tomography (CT) scans and ultrasound can also be used to diagnose salivary gland stones, they are typically not the first-line options due to various factors. CT scans provide a detailed view and are excellent for assessing complex situations, but they are more resource-intensive and expose the patient to radiation. Ultrasound can be useful as well, particularly for assessing superficial stones or when radiation exposure needs to be minimized, but it is less definitive in assessing the entire ductal system compared to a sialogram. MR imaging of the jaw can also demonstrate saliv