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Common Medical Tests for Scleroderma

Author: Shelley Ensz. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
These are commonly used for diagnosing or treating symptoms of Systemic Scleroderma
Antibodies/Blood Tests Tests/Antibodies
Capillaroscopy
Cardiac (Heart)
Gastrointestinal
General
Imaging (CT, MRI)
Medications
Pulmonary (Lung)
Medical Records & References

Antibodies and Blood Tests

Antibody Tests. ISN.
Antibody Tests for Scleroderma. ISN.
Lab Tests Online. A public resource for clinical lab tests. Search for a specific test and learn more about it. Lab Tests Online.
Early systemic sclerosis (SSc): Analysis of the disease course in patients with marker autoantibody or capillaroscopic positivity or both. The data demonstrate faster progression of SSc in autoantibody–positive patients, particularly in those with preclinical internal organ involvement at baseline, than in autoantibody–negative patients. PubMed, Arthritis Care Res (Hoboken), 2014 Feb 10. (Also see: Scleroderma Autoantibodies)
Doctor Groups Issue List of Overused Medical Tests. In an effort to change entrenched medical practices, 17 major medical specialty groups recommended on Thursday that doctors greatly reduce their use of 90 widely used but largely unnecessary tests and treatments. New York Times. 02/21/2013.
Dysregulation of angiogenic homeostasis in systemic sclerosis (SSc). Increased serum endostatin is associated with skin sclerosis severity and pulmonary fibrosis and favors SSc disease progression. PubMed, International Journal of Rheumatic Diseases, 2 Jul 2013. (Also see: Pulmonary Fibrosis, and Prognosis)

Capillaroscopy

Microscope by Shelley Ensz However, very few doctors know how to do a nailfold exam! Viewing the nailfolds with special instruments can disclose certain abnormalities of the small blood vessels, and specific findings can be very useful in diagnosing, classifying and staging forms of systemic scleroderma.
Unfortunately, in the U.S. such testing is frequently not covered by insurance companies, so there is widespread reluctance to do nailfold testing -- even though it is a very quick, easy, noninvasive, and economical way to diagnose and classify systemic forms of scleroderma.

There are occasional patients with changes visible to naked eye. Unfortunately, many doctors mistake prominent venular system (not signficant) with these changes. About 95% of patients need a nailfold exam with magnifying glass or ophthalmoscope on high diopter with oil or KY jelly on the nailbed to assess properly. However, very few doctors do this or even know how. (Also see: What is Scleroderma? and Symptoms of Scleroderma)

Correlations between angiogenic factors and capillaroscopic patterns in systemic sclerosis. Our data revealed decreased endothelial progenitor cell (EPC) counts and increased VEGF levels in patients with the late-NVC pattern. Arthritis Research & Therapy, 04/19/2013.
Capillaroscopy : Procedure and nomenclature. Capillaroscopy has high diagnostic and prognostic value in autoimmune connective tissue diseases, in particular systemic sclerosis (SSc). Our working group has developed a consensus on nomenclature, technical equipment, procedure, and diagnostic interpretation of results. O Sander. Z. (PubMed) Z Rheumatol. 2010 May;69(3):253-62.
Overview
Cuticles: Periungual Erythema
Fingernail Abnormalities
Causes of Fingernail Symptoms and Abnormalities
Lack of Fingerprints
Manicure Safety
Nail Biting
Nailfold Capillaroscopy

Cardiac (Heart)

Heart Disease Tests and Diagnosis. The tests you'll need to diagnose your heart disease depend on what condition your doctor thinks you might have. Mayo Clinic.
Cardiology Tests and Procedures Dozens of cardiac tests clearly explained, including Cardiac Catheterization, Coronary Artery Bypass Graft, Surgery (CABG), Dobutamine Stress Test, Echocardiogram (ECHO), Electrocardiogram (EKG), Electrophysiology Study (EPS), Heart Valve Disorders, Holter Monitoring, Nuclear Medicine Treadmill, Stress Tests (Cardiolite or Thallium), Nuclear Medicine IV Persantine, Stress Test (IVP), Pacemakers, Percutaneous Transluminal, Coronary Angioplasty (PTCA), Signal-Averaged Electrocardiogram, (SAEKG), Stents, Stress Echocardiogram, Transesophageal Echocardiogram, (TEE), and Treadmill Stress Test. Torrance Memorial Medical Center.
Echocardiogram. An echocardiogram (also called an echo) is a type of ultrasound test that uses high-pitched sound waves that are sent through a device called a transducer. The device picks up echoes of the sound waves as they bounce off the different parts of your heart. These echoes are turned into moving pictures of your heart that can be seen on a video screen. WebMD.
Electrocardiogram. An electrocardiogram (EKG or ECG) is a test that checks for problems with the electrical activity of your heart. WebMD.
Stress Echocardiography. Stress echocardiography is a test that uses ultrasound imaging to show how well your heart muscles are working to pump blood to your body. It is mainly used to detect a decrease in blood flow to the heart. MedLine Plus.
Q&A: Contrast for Stress Echo. When is contrast used? What are the FDA warnings and contraindications? Cardiovascular Business.
What Are Holter and Event Monitors? Holter and event monitors are medical devices that record the heart's electrical activity. They are similar to an EKG, both instead of recording the heart's electrical activity for a few second, they record the electrical activity over several days. National Heart Blood and Lung Institute.

Gastrointestinal

Early Endoscopy in Systemic Sclerosis (SSc) Patients Without Gastrointestinal (GI) Symptoms: A Retrospective Analyse. The results of this study might indicate that oesophago-gastro-duodenoscopy should be performed early in patients diagnosed with SSc, even if they do not report typical symptoms. Early treatment of GI involvement might improve the prognosis. R. Thonhofer. [SAT0231] EULAR 2009. (Also see: GI Involvement)
Esophageal Dilation Esophageal dilatation is the technique used to stretch or open the blocked portion of the esophagus. Jackson Gastroenterology

General

Electromyography (EMG): What Is It, and Does It Hurt? So let's get down to the particulars. An electromyography test involves needles. The needles do puncture the skin. Moreover, they enter muscle tissue. But the testing is done with just one needle at a time and just one muscle at a time. Gary E Cordingley, MD, PhD.
Dubious Diagnostic Tests Stephen Barrett, M.D.
Scleroderma: Health Services Utilization from Patients' Perspective. Less than half of patients were diagnosed by a rheumatologist and time to diagnosis from onset of symptoms has remained unchanged over the last 3 decades. Despite their complex, multisystemic disease, less than 50% of patients see sub-specialists or had baseline screening tests for organ involvement of their systemic sclerosis. J Rheumatol 2006 June;33:1123–7. (Also see: Difficult Diagnosis)

Imaging (CT, MRI)

Computerized tomography—also called CT, CT scan and CAT scan—is an X-ray technique that produces more detailed images of your internal organs than do conventional X-ray exams. Mayo Clinic.
Magnetic resonance imaging (MRI) is a technique that uses a magnetic field and radio waves to create cross-sectional images of your head and body. Your doctor uses these detailed, clear images to identify and diagnose a wide range of conditions. Mayo Clinic.

Medications

The Drug Information Search Page The Detroit Medical Center
Medications For others, see the symptoms pages. ISN.

Pulmonary (Lung)

Definition of Chest X-Ray. Chest X-rays produce images of your heart, lungs, blood vessels, ribs and the bones of your spine. If you go to your doctor or the emergency room with chest pain or shortness of breath, chest X-rays can help determine whether you have heart failure, a collapsed lung, pneumonia or broken ribs. Chest X-rays can also reveal fluid in your lungs or in the spaces surrounding your lungs, enlargement of your heart, pneumonia, emphysema, cancer and many other conditions. Mayo Clinic. (Also see: Pulmonary Involvement)

Pulmonary Function Tests (PFT) A test designed to measure how well the lungs are working. MedicineNet.
Pulmonary Function Tests. Pulmonary function tests are tests performed to make measurements of how your lungs and airways function. Results from pulmonary function tests enable your physician to evaluate your breathing, make diagnosis, recommend treatment and follow your progress. This article tells you how to prepare for the test and how it is conducted. National Jewish Medical and Research Center.
Pulmonary Function Testing. Provides information on equipment, procedure and interpretation of pulmonary function tests. Thomas R. Gildea. Cleveland Clinic.
Pulmonary ventilation/perfusion scan. This involves two nuclear scan tests to measure breathing (ventilation) and circulation (perfusion) in all areas of the lungs. Medline Plus.
Thoracentesis Thoracentesis is a procedure to remove fluid from the space between the lining of the outside of the lungs (pleura) and the wall of the chest. Normally, very little fluid is present in this space. An accumulation of excess fluid between the layers of the pleura is called a pleural effusion. Medline (Also see: Pleural Effusion)

Medical Records & References

Medical Tests & Tools: A to Z. WebMD.
 
Go to Medical Tests: Antibodies
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