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)



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)

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