AIR OESOPHAGOGRAM - A FREQUENT, BUT NOT A SPECIFIC SIGN OF ESOPHAGEALINVOLVEMENT IN CONNECTIVE-TISSUE DISEASES

Objective. This study investigates the role of the air oesophagogram i n conventional chest X-rays for the diagnosis of oesophageal dysmotili ty in patients with connective tissue diseases. Methods. Fifty-one pat ients with connective tissue diseases were studied by oesophageal mano metry 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. R esults. A total of 23/51 patients with connective tissue diseases show ed 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 dys motility and air in two or three oesophageal segments (P < 0.05; sensi tivity 48%, specificity 82%). However, the prevalence of an air oesoph agogram showed no significant difference between patients with connect ive tissue diseases and the control group (10/47; 21%).Conclusion. The radiological sign of an air oesophagogram is neither sensitive nor sp ecific enough to omit oesophageal motility studies in patients with co nnective tissue diseases.