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Part of your physical exam may include: Checking for thickened and hardened skin areas (they may use a scoring system, such as the modified Rodnan skin score to help them tell how serious your skin symptoms are) Pressing on your tendons and joints to listen and feel for changes that are related to scleroderma Looking at your fingernails underneath the microscope for swollen small blood vessels (nailfold capillary test) Imaging tests, such as ultrasound and computerized skin scoring, to check how your disease develops over time Blood tests to use in antibody testing Upper gastrointestinal tests Lung function tests, including diffusion capacity Heart tests such as an EKG or right heart catheterization They might also take a small sample of skin (called a biopsy) for a specialist to look at under a microscope