Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Systemic sclerosisLocalized sclerodermaCREST syndrome ++ 701.0 Circumscribed scleroderma710.1 Systemic sclerosis ++ 315.4 Developmental coordination disorder718.03 Articular cartilage disorder, forearm718.04 Articular cartilage disorder, hand718.07 Articular cartilage disorder, ankle and foot718.45 Contracture of joint, pelvic region and thigh719.39 Palindromic rheumatism involving multiple sites719.4 Pain in joint719.70 Difficulty in walking728.2 Muscular wasting and disuse atrophy728.89 Other disorders of muscle, ligament, and fascia729.1 Myalgia and myositis, unspecified729.9 Other disorders of soft tissue736.9 Acquired deformity of limb780.7 Malaise and fatigue781.2 Abnormality of gait782.3 Edema786.0 Dyspnea and respiratory abnormalities786.05 Shortness of breath ++ L94.0 Localized scleroderma [morphea]L94.3 SclerodactylyM34.0 Progressive systemic sclerosisM34.1 CR(E)ST syndromeM34.9 Systemic sclerosis, unspecified ++ 4D: Impaired joint mobility, motor function, muscle performance, and range of motion associated with Connective Tissues Dysfunction14E: Impaired joint mobility, motor function, muscle performance, and range of motion associated with localized inflammation27B: Impaired integumentary integrity associated with superficial skin involvement37E: Impaired Integumentary Integrity Associated With Skin Involvement Extending Into Fascia, Muscle, or Bone and Scar Formation4 +++ Description ++ Autoimmune skin disorderChronic, commonly progressive connective tissue disease considered an autoimmune rheumatic diseaseSkin hardeningIntense fibrosisFinger sensitivity to coldDecreased sweatingMultiple body system involvementOnset often vague, misdiagnoses common +++ Essentials of Diagnosis ++ Etiology unknownSystemic sclerodermaProlonged history of Raynaud’s phenomenon before presenting with swollen fingers, heartburn, shortness of breathLocalized sclerodermaMorphea: oval-shaped skin patches with purplish borders that may fade over timeLinear scleroderma: bands of hardened skin on extremities or forehead, usually on one side of body +++ General Considerations ++ May result in secondary problems indicating need for PT intervention depending on severity: aerobic capacity and muscle endurance impairment, sarcopenia, weakness, musculoskeletal problems, neuromuscular problems, weight lossBecause scleroderma frequently refers or causes pain in various body areas, individuals may be inappropriately referred to PT, such as when referred to low back, upper back, chestHistory of heartburn or indigestion may be related to scleroderma or may indicate GI or cardiac problemIndividuals with scleroderma have twice the incidence of breast and bronchoalveolar cancer than rest of population +++ Demographics ++ Females-to-male ratio: 7:1Systemic scleroderma more common in adults; localized scleroderma most common in childrenBetween 2 and 20 cases per million peopleCan affect individuals of any age; most frequent onset between 25 to 55 years of age, average onset in 40sDecreased incidence after age 60 yearsSome indication of genetic familial tendencyMore common in CaucasiansMore severe in African and Native Americans +++ Signs and Symptoms ++ Raynaud’s phenomenonGastroesophageal reflux disease (GERD)Skin changes: change in color or thickening (sclerodactyly) usually on ... Your Access profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free a profile for additional features.