Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification.
- Abdominal ultrasonography (ultrasound examination of the abdominal organs).
- If involvement of the gastrointestinal tract (gastrointestinal tract) is suspected (clinical symptoms: dyspepsia (irritable stomach), dysphagia (dysphagia), weight loss, diarrhea (diarrhea)).
- If renal crisis is suspected (increased blood pressure, creatinine increase).
- Computed tomography of the thorax/chest (thoracic CT); preferred here: high-resolution computed tomography (HRCT; slice thickness ≤ 2 mm); without contrast medium administration [detection of interstitial lung disease (ILD); this has an impact on the prognosis of patients with systemic sclerosis (SSc): lung: milky glass-like opacities of the lung (= alveolitis/lung cystitis)] (procedure is considered the gold standard)
- Computed tomography (CT; sectional imaging procedure (X-ray images from different directions with computer-based evaluation)) – if organ involvement is suspected.
- X-ray of the chest (X-ray thorax/chest), in two planes – if lung involvement is suspected [not sufficiently sensitive: HRCT (see above) is preferable]
- Perfusion/ventilation scintigraphy – to exclude chronic thromboembolic pulmonary hypertension (due to thrombosis or embolism-related pulmonary hypertension).
- Esophagogastroduodenoscopy (endoscopic examination of the esophagus (esophagus), stomach (gastric) and duodenum (duodenum) and colonoscopy (colonoscopy) – if involvement of the gastrointestinal tract (gastrointestinal tract) is suspected.
- Echocardiography (echo; cardiac ultrasound) – when cardiac involvement and pulmonary arterial hypertension (PAH; increased pressure in the pulmonary artery system) are suspected.
- Electrical impedance analysis (measurement of body compartments/body composition) – for determination of body fat, extracellular body mass (blood and tissue fluid), body cell mass (muscle and organ mass), and total body water including body mass index (BMI, body mass index) and waist-to-hip ratio (THV).
- Nail fold microscopy (changes in the vessels under the microscope) – to detect Raynaud’s syndrome.
- Spirometry (basic examination as part of pulmonary function diagnostics) and determination of diffusion capacity – if pulmonary involvement is suspected (clinical symptoms: dyspnea (shortness of breath), cough, exercise-induced insufficiency) [reveals only advanced, usually restrictive changes]Early changes in pulmonary function can be detected with the determination of CO diffusion capacity. This allows statements about the oxygen exchange in the lungs.
- Gastroscopy (gastroscopy)/colonoscopy (colonoscopy) – gastrointestinal bleeding (gastrointestinal bleeding).
- Arthrosonography (ultrasound examination of the joints) if necessary also conventional X-ray examination – for arthralgias (joint pain), joint swelling.
- Salivary gland sonography (ultrasound of the salivary glands) and Schirmer test (measurement of tear production amount; for this purpose, a 5 mm wide and 35 mm long filter paper strip (litmus paper) is hung in the outer corner of the eyelid in the conjunctival sac; after 5 minutes, the distance is read off, which the tear fluid has traveled in the paper strip; a xerophthalmia (drying of the conjunctiva and cornea of the eye) is present at a distance < 10 mm) – in the sicca syndrome (” dry eye”).
- Right and left heart catheterization – to exclude coronary artery disease (CAD; coronary artery disease).
