Air oesophagogram: a frequent, but not a specific sign of oesophageal involvement in connective tissue diseases.
OBJECTIVE
This study investigates the role of the air oesophagogram in conventional chest X-rays for the diagnosis of oesophageal dysmotility in patients with connective tissue diseases.


METHODS
Fifty-one patients with connective tissue diseases were studied by oesophageal manometry and lateral and posterior-anterior chest X-rays. The presence or absence of oesophageal air on chest X-rays were evaluated separately in the upper, middle and distal segment of the oesophagus. Forty-seven chest X-rays of patients without connective tissue diseases, who had undergone manometry for the evaluation of oesophagus-related symptoms and who had normal oesophageal function, were analysed as a control.


RESULTS
A total of 23/51 patients with connective tissue diseases showed oesophageal dysfunction in manometry; 16/51 patients (31%) had air in two or more oesophageal segments on the lateral chest X-ray. There was a significant association of manometrically proven oesophageal dysmotility and air in two or three oesophageal segments (P < 0.05; sensitivity 48%, specificity 82%). However, the prevalence of an air oesophagogram showed no significant difference between patients with connective tissue diseases and the control group (10/47; 21%).


CONCLUSIONS
The radiological sign of an air oesophagogram is neither sensitive nor specific enough to omit oesophageal motility studies in patients with connective tissue diseases.
Lock
G
G
Department of Internal Medicine I, University of Regensburg, Germany.
Strotzer
M
M
Straub
R H
RH
Schölmerich
J
J
Feuerbach
S
S
Holstege
A
A
Lang
B
B
D000388:Air; D003240:Connective Tissue Diseases / Q000150:complications* / Q000503:physiopathology; D015154:Esophageal Motility Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D004947:Esophagus / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008365:Manometry; D011859:Radiography; D012680:Sensitivity and Specificity