Keyword for Investigation, Referral to specialist and writing of medial records by MCTD 4/5 (1)

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Diagnosis is based on

Medical examinations

Disease history

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

Clinical examination

By clinical investigation, special consideration is given:

  • Swollen fingers (puffy hands)?
  • 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)


  • Capillary neoangiogense, megacapillaries (not all)

CT lungs (frosted glass, fibrosis)



Norwegian Directorate of Health (Supervisor for referrals)

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