Last reviewed 05/2021

The investigation of systemic sclerosis consists of:

  • immunological tests:
    • anti-nuclear antibodies are usually positive
    • anti-Scl-70, anti-centromere & anti-nucleolus may be positive
      • anti-centromere antibody is a good predictor for limited cutaneous systemic sclerosis (formerly known as CREST) (sens 60%, spec 90%)
      • Scl-70 antibody is a good predictor of diffuse disease (sens 38% spec 100%)
    • cold agglutinins may cause an acquired haemolytic anaemia

  • haematological:
    • a normochromic normocytic anaemia is common
    • the ESR may be elevated

  • radiological:
    • plain radiographs of the hands:
      • may show calcium in the skin of the fingers
      • severe cases show resorption of distal phalanges
    • barium swallow may detect oesophageal involvement


  1. C M Black; Systemic sclerosis; OTM 3rd Ed 3 p3027-35