Scleroderma - Diagnosis

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Diagnosing Gastrointestinal (Digestive) Complications. Gastrointestinal problems may be detected using endoscopy. Endoscopy is an invasive procedure in which a tube is inserted down the esophagus. The tube contains a small camera and other instruments. Another diagnostic test is manometry, a test that measures the pressure that the muscles in the esophagus apply. Electrogastrography (EGG) measures the electrical activity in muscles in the stomach, and may be an effective method for detecting stomach problems.

Diagnosing problems in growth of blood vessels. Capillaroscopy is the microscopic examination of blood vessels under the skin. It is now considered a useful tool for identifying problems with the growth of blood vessels. Such problems can show the severity and progression of scleroderma.

Click the icon to see an image about endoscopy.

Ruling out Other Conditions

Other Autoimmune and Connective Tissue Disorders. Several other autoimmune conditions that affect connective tissue can strongly resemble, and even occur together, with scleroderma. They include the following:

• Rheumatoid arthritis
• Systemic lupus erythematosus
• Polymyositis

Symptoms of such diseases may also include fever, arthritis, muscle aches, rash, and lung and heart problems.

Eosinophil Fasciitis. Eosinophilic fasciitis is a muscle disorder that is known to occur after intense hard work. It can cause symptoms similar to scleroderma, including pain, swelling, and tenderness in the hands and feet, as well as skin thickening. The disorder can be ruled out if blood tests show elevated sedimentation rate and no antinuclear antibodies.

Although Raynaud's phenomenon occurs in most scleroderma patients, over 80% of the cases of Raynaud's phenomenon are harmless. In one study, only 12% of Raynaud's cases were associated with some other condition, and few of those were scleroderma. The following are other problems that might accompany or cause Raynaud's phenomenon:

• Other autoimmune connective tissue diseases
• Diabetes. Patients with diabetes may develop Raynaud's phenomenon and other scleroderma-like symptoms.
• Certain drugs including bleomycin, ergot derivatives (used for migraines), and methysergide
• Hereditary hemorrhagic telangiectasia is very similar to CREST syndrome and poses a diagnostic problem for the doctor, although it is very rare.
• Keloids are areas of scarring overgrowth on the skin that develop at the site of skin injuries. They are caused by genetic factors and are most likely to occur in African-Americans. Extensive keloids may be mistaken for scleroderma.

Click the icon to see an image of a keloid.

• Repetitive stress injuries (particularly from vibrating tools)
• Hypothyroidism

Review Date: 12/14/2006
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).