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How is primary sclerosing cholangitis (PSC) diagnosed?

Olympic Snowboarder Chris Klug talks about the diagnosis of primary sclerosing cholangitis (PSC), a rare liver disease, that led to his need for a liver transplant.


Blood tests to check levels of liver enzymes are the first step in diagnosing PSC. Doctors confirm the diagnosis using cholangiography, which provides pictures of the bile ducts.

Cholangiography can be performed in the following ways:

Endoscopic retrograde cholangiopancreatography (ERCP): ERCP uses an endoscope-a long, flexible, lighted tube-that goes down the mouth, beyond the stomach, and into the duodenum to reach an area in the digestive tract where dye can be injected into the bile ducts. X-rays are taken when the dye is injected. ERCP also can be used to take a tissue sample or to treat blocked ducts. Percutaneous transhepatic cholangiography (PTC): This procedure involves inserting a needle through the skin and placing a thin tube into a duct in the liver. Dye is injected through the tube and x-rays are taken. Magnetic resonance cholangiopancreatography (MRCP): MRCP uses magnetic resonance imaging (MRI) to obtain pictures of the bile ducts. MRI use radio waves and magnets to scan internal organs and tissues. MRCP does not involve using x-rays or inserting instruments into the body. This safe and painless test is being increasingly used for diagnosis.

Other testing may include ultrasound exams and a liver biopsy. Ultrasound uses sound waves to create images of organs inside the body. A biopsy involves removal of a small piece of tissue for examination under a microscope.

This answer is based on source information from National Institute of Diabetes and Digestive and Kidney Diseases.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.