Sialolithiasis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mehrian Jafarizade, M.D [2]

Overview

Sialolithiasis must be differentiated from other diseases that cause swelling in salivary glands, such as acute bacterial sialadenitis, chronic bacterial sialadenitis, viral sialadenitis, human immunodeficiency virus, radiation, and systemic diseases such as, sarcoidosis, and sjögren's syndrome.

Differentiating Sialolithiasis from other Diseases

Sialolithiasis must be differentiated from other diseases that cause swelling in salivary glands, such as acute bacterial sialadenitis, chronic bacterial sialadenitis, viral sialadenitis, human immunodeficiency virus, radiation, and systemic diseases such as, sarcoidosis, and sjögren's syndrome.

Differentiating Sialolithiasis from other Diseases table

Diseases	Symptoms and sign							Laboratory Findings		Other Findings
	Onset	Unilateral/Bilateral	Pain	Swelling	Tenderness	Purulent discharge	Common site of involvement	ESR	Leukocytosis
Sialolithiasis	Acute	Unilateral	+	+	+	-	Submandibular gland	↑/NL	↑/NL	Radio-opaque in X-ray
Acute bacterial sialadenitis	Acute	Unilateral	+	+	+	+	Parotid	↑	↑	Other sign of infection may be present
Chronic bacterial sialadenitis	Chronic	Unilateral	+	+	-	+/-	Parotid	↑	↑	Other sign of infection may be present
Viral sialadenitis	Acute	Bilateral	+	+	+	-	Parotid	↑	↑	Coryza symptoms
Human immunodeficiency virus	Acute	Bilateral	+	+	-	-	Parotid	NL	NL	Other systemic findings of HIV/ check ELIZA
Radiation sialadenitis	Acute	Unilateral	+	+	+	-	Depends on the treatment field	NL	NL	History of radiation in the salivary gland site
Salivary gland tumors	Subacute	Unilateral	-	+	-	-	Parotid	↑/NL	↑/NL	Advance age
Sarcoidosis	Gradual	Bilateral	-	+	-	-	Parotid	↑	↑	Systemic findings in other organs
Sjögren's syndrome	Gradual	Bilateral	+/-	+	-	-	Parotid or submandibular glands	↑/NL	↑/NL	Dry eye/dry mouth
Malnutrition	Gradual	Bilateral	+/-	+	-	-	Parotid	NL	NL	Systemic findings in other organs