Medical Health Encyclopedia

Diagnosing Gastrointestinal Complications. Gastrointestinal problems may be detected using endoscopy (the insertion of a tube down the esophagus that contains a small camera and other instruments) or with manometry, a test that measures the pressure exerted by the muscles in the esophagus. Electrogastrography (EGG) measures the electrical activity in muscle 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 be used to determine 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. A number of 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.

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

Eosinophil Fasciitis. Eosinophilic fasciitis is a muscle disorder that is known to occur after intense exertion. 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.

Conditions Associated with Raynaud's phenomenon and other Symptoms of Scleroderma. Although Raynaud's phenomenon occurs in most scleroderma patients, over 80% of cases of Raynaud's phenomenon are harmless. In one study, only 12% of Raynaud's cases was associated with some other condition, and few of those are 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. This is very similar to the CREST syndrome and poses a diagnostic dilemma for the physician, 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.