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.
Department of Internal Medicine I, University of Regensburg, Germany.
G
G
Lock
M
M
Strotzer
R H
RH
Straub
J
J
Schölmerich
S
S
Feuerbach
A
A
Holstege
B
B
Lang
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