Achalasia versus Scleroderma

How can a barium swallow distinguish achalasia from scleroderma? 

If the condition results in dysmotility that is at least moderate in severity, barium swallow abnormalities are usually different in these two conditions.

Achalasia versus Scleroderma

Esophageal DilatationPeristalsis in Pure Smooth Muscle Part of EsophagusEsophagogastric Junction
AchalasiaMay be markedAbsentBeak: smooth, concentric, tapered, flexible
No hiatus hernia
SclerodermaMinimal or moderateWeak, incomplete, or absentStricture from esophagitis: cylindrical, rigid, sometimes irregular or ulcerated
Often a sliding hiatus hernia

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