• Diagnosis of Scleroderma

    There are no specific tests that can completely confirm or eliminate the possibility of scleroderma .
    Your doctor may be able to diagnose scleroderma by taking a careful history of your symptoms and doing a thorough physical examination. Your doctor will look for classic skin changes associated with scleroderma, including calcium deposits under the skin and changes in the tiny blood vessels (capillaries) at the base of your fingernails. The skin changes of scleroderma are often characteristic enough to allow your doctor to accurately diagnose the condition.
    If there are any questions, your doctor may recommend other tests to confirm the diagnosis or to evaluate how severely your internal organs are involved.
    Such tests may include:

    Blood Tests

    A number of blood tests can point towards the presence of scleroderma. These include:
    • Rheumatoid factor
    • Erythrocyte sedimentation rate
    • Antinuclear antibody
    • Scleroderma antibody
    • Anticentromere antibody

    Imaging Tests

    These tests can visualize the internal organs to see how the disease has affected them. Specific areas of the body to be examined with imaging tests may be chosen based on your symptoms. Imaging tests include:
    • X-rays —a test that uses radiation to take a picture of structures inside the body
    • CT Scans —a type of x-ray that uses a computer to make pictures of structures inside the body
    • MRI Scans —a test that uses magnetic waves to make pictures of structures inside the body
    • Nailfold capillaroscopy—This test involves looking at a magnified view of the nailfold to examine the capillaries.

    Skin Biopsy

    A skin biopsy involves removing a small sample of skin and examining it in a lab for specific characteristics that suggest scleroderma.

    Organ Specific Tests

    Depending on your symptoms, your doctor may order tests of other organs to see if they are involved in the disease process. These tests may include:

    References

    Braunwald E. Harrison’s Principles of Internal Medicine. 15th ed. New York, NY: McGraw-Hill; 2001.

    Ferri F, ed. Ferri’s Clinical Advisor 2011. Philadelphia, PA: Mosby Elsevier; 2010.

    Firestein E, Kelley W. Kelley’s Textbook of Rheumatology. 8th ed. Philadelphia, PA: Saunders; 2008.

    Goldman L, Ausiello D, eds. Cecil Textbook of Internal Medicine. 23rd ed. Philadelphia, PA: Saunders; 2008.

    Habif TP. Clinical Dermatology. 4th ed. St. Louis, MO: Mosby; 2004.

    National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ .

    Noble J, Greene H. Textbook of Primary Care Medicine. St. Louis, MO: Mosby; 1996.

    Rakel R. Textbook of Family Medicine 2007. 7th ed. Philadelphia, PA: Saunders Elsevier; 2009.

    Rakel R, Bope E. Conn's Current Therapy. 60th ed. Philadelphia, PA: Saunders Elsevier; 2009.

    Scleroderma Foundation website. Available at: http://www.scleroderma.org/ .

    Sleisenger M, Feldman M, Friedman L, Brandt L. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 8th ed. St. Louis, MO: Mosby; 2005.

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