GIT manifestations of sclerodermaLocation:• Esophagus (most common location).• Stomach.• Small bowel.• Colon.
Esophageal sclerodermaLocation:Lower 2/3 (contain smooth muscles).Pathology:Smooth muscle atrophy.Motility disorder:Decreased peristalsis.Reflux.Radiological:• Dilatation of the lower 2/3 of the esophagus.• Patulous gastro-esophageal junction.• Loss of longitudinal folds.• Esophageal candidiasis.
Small bowel sclerodermaLocation:• Most common duodenum.Pathology:Preferential atrophy of the inner circular smooth muscle layerrelative to the outer longitudinal layerContraction of the longitudinal layer result in foreshortening ofthe bowel & packing of valvulae conniventes.Motility disorder:• Decreased peristalsis (fluoroscopy).• Delayed small bowel transit time.Radiological manifestations:• Hidebound sign (crowding of valvulae conniventes).• Small bowel dilatation (mega-duodenum or mega-jejenum).
Colonic sclerodermaMotility:Reduced colonic transit time.Radiology:Colonic dilatation.Loss of haustration.Pseudo-sacculation.
Skeletal manifestations ofsclerodermaLocation:• The hands are the most common location.Pathology:Radiology:Bone changes:• Acro-osteolysis (resorption of terminal phalanges).• Joint space narrowing.• Erosions.Soft tissue changes:• Subcutaneous & peri-articular calcification.• Atrophy specially at the tips of finger.• Flexion deformities.