Scleroderma is often hard to diagnose, since it may look like many other diseases. Your doctor will do a physical exam and take your medical history. He or she will look for changes in skin thickness and do some tests.
One test that doctors use is the nail-fold capillary test. This focuses on one of the earliest signs of scleroderma: the disappearance of tiny blood vessels in the skin of the hands and feet. Doctors also check the blood for specific signs. Your doctor may remove a small tissue sample...
know what causes spondyloarthropathies. The presence of a particular
gene, HLA-B27, is often linked to ankylosing
spondylitis. Spondyloarthropathies are more likely to run in families than
other forms of rheumatic disease, such as
lupus or rheumatoid arthritis.
Although spondyloarthropathies all result in joint pain,
each type also has specific symptoms.
Ankylosing spondylitis causes stiffness and low
back pain. Over time, the pain usually moves from the lower back into the upper
back. In severe cases, the affected joints in the
spine fuse together, causing severe back stiffness.
Other areas (such as the hips, chest wall, and heels) may also be affected. In
children, symptoms usually begin in the hips, knees, heels, or big toes and
later progress to the spine.
Reiter's syndrome causes pain,
inflammation of the joints, especially in the
sacroiliac joint, the attachment between the lower back and pelvis, and in the
fingers, toes, and feet. The fingers and toes may swell, causing a "sausage
digit." Reiter's syndrome can also cause fever, weight loss, skin rash, and
inflammation. In children, the joints of the lower legs are most commonly
Psoriatic arthritis is a form of arthritis associated
with a skin condition called
psoriasis. The psoriasis symptoms (scaly red patches
on the skin) often precede the arthritis symptoms, sometimes by many years. The
severity of the rash does not mirror the severity of the arthritis. The
fingernails and toenails may show pitting or thickening and yellowing. The
joint problems involve large joints, such as the hips and sacroiliac joints.
Swelling of entire toes or fingers, resulting in sausage digits, also
Enteropathic arthritis is spinal arthritis that also
involves inflammation of the intestinal wall. Symptoms can come and go, and
when the abdominal pain is flaring, this arthritis may also flare. The
arthritis typically affects large joints, such as the knees, hips, ankles, and
elbows. In children, the arthritis may begin before the intestinal
A general difference between spondyloarthropathies and
juvenile spondyloarthropathies is that in adults, the spine generally is
affected, while in children the arms and legs are more frequently affected.
Children may have 4 or fewer joints that are painful or swollen (typically the
knees or ankles), inflammation of a part of the eye (iritis), and
neck pain and stiffness.
Spondyloarthropathies may cause
inflammatory eye disease, particularly
uveitis. In some cases, spondyloarthropathies can
cause disabilities, particularly if bones in the spine fuse together. People
who have spondyloarthropathies for a long time may develop complications in
organs, such as the heart and lungs.
How are spondyloarthropathies diagnosed?
Spondyloarthropathies are diagnosed through a medical history, laboratory
tests, and by symptoms of joint and tissue inflammation, morning stiffness, and
other symptoms unique to a specific spondyloarthropathy (such as scaly skin in
psoriatic arthritis). Different types of tests may be done for the different
How are spondyloarthropathies treated?
cases spondyloarthropathies are mild and may be undiagnosed for many years.
Most people do not have trouble with daily activities. Treatment is focused
on relieving pain and stiffness and on good posture and stretching of the
affected areas to prevent stiffening and deformity.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are
commonly used to treat pain and inflammation linked to
spondyloarthropathies. Other treatment options depend on the type of
spondyloarthropathy you have. For example, medicines are used to treat
intestinal inflammation in enteropathic arthritis.
Primary Medical Reviewer
Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer
Stanford M. Shoor, MD - Rheumatology
May 11, 2011
WebMD Medical Reference from Healthwise
May 11, 2011
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