The list of medical tests mentioned in various sources as used in the diagnosis of Scleroderma includes:
Depending on your particular symptoms, a diagnosis of scleroderma may be made by a general internist, a dermatologist (a doctor who specializes in treating diseases of the skin, hair, and nails), an orthopaedist (a doctor who treats bone and joint disorders), a pulmonologist (lung specialist), or a rheumatologist (a doctor specializing in treatment of rheumatic diseases). A diagnosis of scleroderma is based largely on the medical history and findings from the physical exam. To make a diagnosis, your doctor will ask you a lot of questions about what has happened to you over time and about any symptoms you may be experiencing. Are you having a problem with heartburn or swallowing? Are you often tired or achy? Do your hands turn white in response to anxiety or cold temperatures?
Once your doctor has taken a thorough medical history, he or she will perform a physical exam. Finding one or more of the following factors can help the doctor diagnose a certain form of scleroderma:
Finally, your doctor may order lab tests to help confirm a suspected diagnosis. At least two proteins, called antibodies, are commonly found in the blood of people with scleroderma:
A number of other scleroderma-specific antibodies can occur in people with scleroderma, although less frequently. When present, however, they are helpful in clinical diagnosis.
Because not all people with scleroderma have these antibodies and because not all people with the antibodies have scleroderma, lab test results alone cannot confirm the diagnosis.
In some cases, your doctor may order a skin biopsy (the surgical removal of a small sample of skin for microscopic examination) to aid in or help confirm a diagnosis. However, skin biopsies, too, have their limitations: biopsy results cannot distinguish between localized and systemic disease, for example.
Diagnosing scleroderma is easiest when a person has typical symptoms and rapid skin thickening. In other cases, a diagnosis may take months, or even years, as the disease unfolds and reveals itself and as the doctor is able to rule out some other potential causes of the symptoms. In some cases, a diagnosis is never made, because the symptoms that prompted the visit to the doctor go away on their own. (Source: excerpt from Handout on Health Scleroderma: NIAMS)
The following medical news items are relevant to diagnosis and misdiagnosis issues for Scleroderma:
16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about diagnostis of Scleroderma.
Typical cutaneous changes provide the first clue to diagnosis. Results of diagnostic tests include:
❑ blood studies — slightly elevated erythrocyte sedimentation rate, positive rheumatoid factor in 25% to 35% of patients, and positive antinuclear antibody test
❑ chest X-rays — bilateral basilar pulmonary fibrosis
❑ electrocardiogram — possible nonspecific abnormalities related to myocardial fibrosis
❑ GI X-rays — distal esophageal hypomotility and stricture, duodenal loop dilation, small-bowel malabsorption pattern, and large diverticula
❑ hand X-rays — terminal phalangeal tuft resorption, subcutaneous calcification, and joint space narrowing and erosion
❑ pulmonary function studies — decreased diffusion and vital capacity and restrictive lung disease
❑ skin biopsy — may show changes consistent with the disease’s progress, such as marked thickening of the dermis and occlusive vessel changes
❑ urinalysis — proteinuria, microscopic hematuria, and casts (with renal involvement).
Source: Professional Guide to Diseases (Eighth Edition), 2005
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