Your doctor may have to request several tests to confirm scleroderma diagnosis as there is no single test available to give an accurate identification. Your doctor will order these tests basing on the history of your presenting symptoms along with the physical exam. Physical examination includes checking the skin for areas of unusual thickness. Thickening and hardening of the skin are usually seen around the fingers and toes. Tendons and joints are also pressed to see if there are any unusual grating sensations that indicate musculoskeletal changes. Antinuclear antibody (ANA) tests are done to detect specific ANA that may indicate presence of scleroderma. This is done for scleroderma is believed to be a condition caused by an abnormal autoimmune system. Rheumatoid factor, anti-single-stranded DNA, and antihistone antibodies are auto antibodies that doctors correlate with scleroderma. Anti-RNA polymeras III, anti-topoisomerase I (or anti-DNA topo 1) and anti-centromere antibodies (ACA) are also auto antibodies that are tested for scleroderma diagnosis. Presence of one or more of these auto antibodies is noted in patients suffering from systemic scleroderma. These antibodies do not necessarily have to be present at the same time. Some antibodies are present in a certain stage, and others are found in a different phase of the disease.
Scleroderma can also present systemic complications. Separate tests are done for each body system to arrive at a definitive scleroderma diagnosis. Lung involvement is tested through listening with the aid of a stethoscope for presence of riles. These are crackling sounds heard at the base of the lungs as the patient breathes in. This often indicates pulmonary fibrosis, a complication brought about by scleroderma. X-rays can also be done, although lung disease is not often noted in this imaging test especially in children. CT-scans and bronchoalveolar lavage is done if severe lung scarring is suspected. Heart complications are tested with the use of an ECG, echocardiography, and radio nucleotide ventriculography.
These are just some of the tests used to arrive at a scleroderma diagnosis. Other tests are done to detect pulmonary hypertension and gastrointestinal complications brought about by scleroderma. Your doctor will advise you of the right preparations to be done before each tests to help arrive at an accurate result.
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