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
  • Jaccoud's 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 neogenesis, mega capillaries (not at all)

CT lungs (frosted glass, fibrosis)

ECG

Ekkocardiografi

• Pulmonary hypertension in approximately 4%

Referral to specialist

Patients resident in Oslo can be referred to Rheumatology Department, Rikshospitalet: Postbox 4950 Nydalen, 0424 OSLO. The department receives from the Health Region South East and from the rest of the country as far as capacity is concerned.

Norwegian Directorate of Health (Supervisor for referrals)

• MCTD, BINDEVEVSSYKDOMMER.no
• Bindevevssykdommer.no
• Vaskulitt.no