Title: CREST Syndrome Clinical Presentation: History, Physical Examination, Complications
Headings: CREST Syndrome Clinical Presentation
CREST Syndrome Clinical Presentation
History
Calcinosis
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectases
Other manifestations

Content: Rarely, the nose and ears can be affected. Involved skin is cool during the attack, but the proximal skin is warm. Color changes are often accompanied by symptoms that can include pain and paresthesias. The phenomenon lasts minutes to hours, and the patient is symptom-free between episodes. Esophageal dysmotility
While the entire intestine can be involved in scleroderma, esophageal involvement is most common and most often clinically relevant. According to Akesson and Wollheim from 1989, [ 44] dysmotility is common. Cine-esophagram and radionuclide transit time studies demonstrate hypomotility in as many as 75-86% of patients with CREST syndrome. All patients have normal motility of the proximal esophagus, which primarily is striated muscle. In 1987, Zamost et al [ 45] correlated esophageal symptoms with anatomic and physiologic measurements in 53 patients with scleroderma. The prevalence of esophagitis and strictures (41%) in this patient population is higher than in otherwise healthy patients with gastroesophageal reflux disease.