Radionuclide transit (RT) is a noninvasive test of esophageal function with a sensitivity equivalent to manometry. Using RT, 34 patients with progressive systemic sclerosis (PSS), 15 with diffuse scleroderma and 18 with the CRST variant, were studied and compared to 22 patients with other connective tissue diseases and 20 normal volunteers. Abnormalities were present in 87% of patients with diffuse scleroderma, 72% with CRST, 38% with other connective tissue diseases and in none of the controls. The most frequent abnormality in PSS was that of adynamic transit. Abnormalities correlated with disease duration in the diffuse scleroderma group but not the CRST group. There was a positive association between abnormal RT and the presence of esophagitis in the PSS patients (p = 0.003).