musculoskeletal and connective tissue disorders
Mixed Connective Tissue Disease (MCTD)
Symptoms and Signs of MCTD
 Raynaud Syndrome (Raynaud phenomenon) may precede other manifestations by years. Frequently, the first manifestations resemble early Initial, diffuse swelling of the hands is typical but not universal. Skin findings include lupus or dermatomyositis-like rashes. Diffuse systemic sclerosis–like skin changes and ischemic necrosis or ulceration of the fingertips may develop. Almost all patients have polyarthralgias, and 75% have frank arthritis. Often the arthritis is nondeforming, but erosive changes and deformities similar to those in rheumatoid arthritis (eg, Boutonnière Deformity and Renal involvement (most commonly Membranous Nephropathy ) occurs in about 25% of patients and is typically mild; severe involvement, with morbidity or mortality, is atypical for MCTD. The lungs are affected in up to 75% of patients with MCTD. 