Undifferentiated Connective-Tissue Disease Treatment & Management

  • Author: Bernard Hildebrand, MD, MA; Chief Editor: Herbert S Diamond, MD  more...
Updated: Apr 16, 2015

Medical Care

A patient with undifferentiated connective-tissue disease (UCTD) can be evaluated and treated primarily as an outpatient.


Surgical Care

Surgery for patients with UCTD is not routinely necessary and should be initiated only when indicated for diagnosis or treatment.



See the list below:

  • A rheumatologist should be consulted.
  • Consultations with other specialists may be clinically indicated, including with a dermatologist, ophthalmologist, pulmonologist, cardiologist, neurologist, physical medicine specialist, physical therapist, and/or occupational therapist.


No special diet is recommended for patients with UCTD.



See the list below:

  • In general, activities are not restricted in the absence of specific functional limitations associated with UCTD.
  • Patients with photosensitivity should minimize prolonged exposure to sunlight and should use protective clothing and sunblock lotions/creams to protect against ultraviolet light.
  • Patients with severe Raynaud phenomenon should avoid prolonged exposure to severe cold temperatures (< 40° F) to avoid digital vasospasm. Layered clothing, hats, and gloves help to maintain a warm core body temperature and decreased vasospastic symptoms. Tobacco use should be avoided.
Contributor Information and Disclosures

Bernard Hildebrand, MD, MA Associate Program Director, San Antonio Military Medical Center Rheumatology Fellowship

Bernard Hildebrand, MD, MA is a member of the following medical societies: American College of Physicians, American College of Rheumatology, American Society for Bioethics and Humanities

Disclosure: Nothing to disclose.


Daniel F Battafarano, DO MACP, FACR, Chief, Rheumatology Service, San Antonio Military Medical Center; Professor of Medicine, Uniformed Services University of the Health Sciences, F Edward Hebert School of Medicine; Adjunct Professor of Medicine, University of Texas Health Science Center at San Antonio

Daniel F Battafarano, DO is a member of the following medical societies: American College of Physicians, American College of Rheumatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Elliot Goldberg, MD Dean of the Western Pennsylvania Clinical Campus, Professor, Department of Medicine, Temple University School of Medicine

Elliot Goldberg, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology

Disclosure: Nothing to disclose.

Chief Editor

Herbert S Diamond, MD Visiting Professor of Medicine, Division of Rheumatology, State University of New York Downstate Medical Center; Chairman Emeritus, Department of Internal Medicine, Western Pennsylvania Hospital

Herbert S Diamond, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology, American Medical Association, Phi Beta Kappa

Disclosure: Nothing to disclose.

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Table 1. Preliminary Classification Criteria for Undifferentiated Connective-Tissue Disease
Inclusion CriteriaClinical

Exclusion Criteria (Applicable to patients at disease onset)

Laboratory Exclusion Criteria (Applicable to patients at disease onset)
1. Signs and symptoms suggestive of a CTD but not fulfilling the diagnostic or classification criteria for any of the defined CTDs (using previously established classification criteria for SLE, MCTD, SSc, PM/DM, RA and SS) for at least 3 years. If the disease duration is less than 3 years, patients may be defined as having an early UCTD.

Adapted from Mosca et al[10] and Doria et al.[19]

2. Presence of antinuclear antibodies determined on two different occasions

Malar rash

Subacute cutaneous lupus

Discoid lupus

Cutaneous sclerosis

Heliotrope rash

Gottron papules

Erosive arthritis









Table 2. Predictors of Progression to Definite Connective-Tissue Disease
Connective-Tissue Disease AssociationSigns or SymptomsLaboratory Data
Systemic lupus erythematosusAge, fever, photosensitivity, serositis, alopeciaANA, Anti-dsDNA, Anti-Smith, Anti-cardiolipin antibodies, Coombs positivity, leukopenia
Systemic sclerosisSclerodactyly, Raynaud phenomenon, sicca symptoms, esophageal dysfunctionANA with nucleolar pattern
Sjögren syndromeXerostomia, xerophthalmia, Raynaud phenomenonAnti-SSA, Anti-SSB
Rheumatoid arthritisSymmetric polyarthritisRF, elevated ESR (>70 mm/h)
Mixed connective-tissue diseaseEsophageal reflux, polyarthritis, Raynaud phenomenonANA, Anti-U1-RNP
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