Diagnosis is based on

• Disease history
• Clinical examination
• RNP antibody (required!)
• Exclude other cause of illness (Differential diagnosis)

Medical examinations

Disease history

• Time and symptoms of disease start (Raynaud's phenomenon and non-Raynaud's symptoms)
• Time of diagnosis

• "Puffy Hands" (Early finding)
• Raynaud's phenomenon (in most cases)
• Arthritis (rarely erosive, often in small joints)
• Myositis (Often low grade with slightly elevated CK and few symptoms)
• Sclerodactylia (transition towards Systemic sclerosis)
• Fatigue / exhaustion
• Eczema (note! SLE)
• Kidney Disorders (Obs! SLE)
• Heart / lungs (note! SLE)
• Fever (Obs! SLE)
• Cytopenia (obs! SLE)
• RNP antibody

Clinical examination

By clinical investigation, special consideration is given:

• Swollen fingers (puffy hands)?
• Arthritis
  • Jaccouds arthropathy or destructive arthritis
• Myositissign
  • Muscle atrophy
  • Reduced force (symmetrical, proximal or distal, rises from the hernia and from the chair without support?
  • High CK and LD in blood
• Sclerodactylia?
• Eczema (SLE-like)
• Kidney
  • Glomerulonephritis: differential diagnosis SLE
• Lungs
  • Pleurisy
• Heart Disorders
  • Pericarditis (rare)
  • Pulmonary hypertension (rare)

Blood tests

• Antibodies (RNP is mandatory)
• Sedimentation rate (ESR) and CRP, cell counts, liver enzymes, renal function, f-T4 and TSH

Urin test

• Exclude proteins and blood (by glomerulonephritis)

Capillaroscopy

• Capillary neoangiogense, megacapillaries (not all)

CT lungs (frosted glass, fibrosis)

ECG

Ekkocardiografi

• Pulmonary hypertension in approx. 4%

Norwegian Directorate of Health (Supervisor for referrals)

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• MCTD, BINDEVEVSSYKDOMMER.no
• Grans Compendium in Rheumatology

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• Bindevevssykdommer.no
• Vaskulitt.no