van Nimwegen JF, et al. - Patients (n=243) who underwent salivary gland ultrasonography (SGUS) were recruited by the researchers in order to determine whether the addition of SGUS or replacement of current criteria items by SGUS would impact the performance of the ACR-EULAR criteria for primary Sjögren's syndrome. The SGUS positivity had an optimal weight as 1. Out of 243, patients who underwent a parotid gland biopsy (n=198), similar outcomes were obtained. A decline in the sensitivity of the criteria was observed when SGUS displaced salivary gland biopsy or anti-SSA antibodies, while performance continued to be equal when SGUS replaced OSS, Schirmer's test or UWS. Hence, the post-incorporation of SGUS, the validity of the ACR–EULAR criteria persisted to be high. Further, to assess the fulfillment of the ACR-EULAR criteria, clinicians are granted a greater array of tests with SGUS.