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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29546
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have been having increasing pain in my hands. I looked it

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I have been having increasing pain in my hands. I looked it up and it is called the metocarpal philangal joints (spelling wrong I know) It has gotten increasingly worse over the last 8 weeks. The joints in my fingers also hurt and get stuck. The pain started in my thumbs and now has moved to all the fingers on both hands. I cannot even come close to making a fist. My hands are becoming very weak. Today I could not even open a car door without using both hands. The stiffness and pain does not cease or get better. They seem a little better if I am using them. I get some relief when i put them in very hot water or put them on a hot surface. I have been to the doctor and blood work has been done. I had high uric acid so i was given medicine to lower it in case it is gout. (Would it be bilateral if it is gout?) I was told it would improve within a week if that was the problem. It has only gotten worse. I know that I have high inflamatory markers and a positive ANA. RA is negative. I have hypermobile joint syndrome or Elhers Danlos III depending on who is doing the diagnosis. I do not know if they are different. I have had carpal tunnel surgery on both wrists. This seems to be progressing very quickly I'm afraid that before we figure this out I'm not going to be able to use my hands at all. Any ideas other than what I have listed. Any ideas on what to do about the pain. It gets so bad that it wakes me in the night.
Submitted: 1 year ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 1 year ago.
Greetings Julia.

One of the possibilities to consider would be seronegative rheumatoid arthritis which can be concomitant to the gout. The high uric acid sometimes can be due to deranged renal function tests, so that should be ascertained with the x-rays and MRI of the hands. Especially this is important as gout treatment has not helped you. Rheumatoid Factor and anti-CCP antibody testing are done for evaluating a patient with suspected Rheumatoid Arthritis. A positive result for either test increases overall diagnostic sensitivity, while the specificity is increased when both tests are positive. Despite this, both tests are negative on presentation in almost half of patients and remain negative during follow-up in 20 percent of patients with rheumatoid arthritis. So Rheumatoid would be still a definite diagnostic possibility in your case. Fibromyalgia, osteoarthritis are the other diagnostic consideration for your symptoms.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

 

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Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29546
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
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