Specificity and sensitivity of esophageal motor abnormality in systemic sclerosis (scleroderma) and related diseases:...

Using cineradiography, we studied esophageal peristalsis in patients with suspected systemic sclerosis and related diseases, and in patients without known esophageal disease who had been referred for upper gastrointestinal series. Patterns of peristaltic abnormality were identified, and specificity and sensitivity values calculated. Esophageal aperistalsis was 100% specific, and consistently weak peristalsis after all, swallows was 88% specific for systemic sclerosis. Specificity decreased to 70% in patients over age 60. Abnormal peristalsis after some, but not all, swallows had only 52% specificity. Consistently abnormal peristalsis (absent or diminished) was 67% sensitive for scleroderma. Although a high sensitivity value (87%) for cineradiography can be obtained by considering any peristaltic abnormality as a sign of scleroderma, this is achieved at the price of an undesirably high number of false positives (specificity 40%).