What is the significance of having a bone erosion seen on a hand/finger x-ray? I am a 30 year old female and had an x-ray of my ring finger after experiencing some pain and mild swelling after boxing (for exercise wearing gloves and hitting a soft surface). No fractures were seen. There was joint space narrowing and an erosion at the PIP joint. I've had mild episodes of hand pain in the past. Do people without underlying rheumatologic conditions get erosions sometimes?
Person's Gender: Female
Person's Age: 30
rest, ice, motrin
so is that the only joint with pain?
well sometimes hand in general only mild
and that is your PIP joint (prox. interphalangeal phalanx)
the second joint
so that is related to trauma and erosion on the epiphysis
there are two other things, osteoarthritis and psoriatic arthritis
so minor trauma could be a possible explanation? Or does trauma not usually cause this?
but rheumatoid gives inflammation of the capsular synovium
well this could be the recent trauma if you see a bone fragment
or it could be old with reabsorption
no fragment was mentioned, just the one erosion and some mild joint space narrowing
you've been boxing a while?
just a few weeks
do you have a family history of osteoarthritis?
the thing is that osteo is usually pretty symmetric on radiological imaging though, and you are only 30
are you sure you haven't traumatized it earlier?
do you have any psoriasis?
seborrheic dermatitis with plaques and patches around your eyebrows?
maybe whenI was a teenager. I don't have psoriasis, though my mother does
family history of psoriasis
yes, my mother
does your mother have arthritis?
not diagnosed, though i suspect she does since her fingers are frequently swollen
well that is a possibility, but then Phil Mickelson has the same thing, and I cannot play golf anywhere nearly as good
but psoriatic arthritis can be a few joints here and there
hang on for one second as I wanted to check something about this ok?
could symptoms of psoriatic arthritis present insidiously with only mild symptoms? Is this worthy of making an appointment with a rheumatologist or should I just wait it out and see how the symptoms are over time?
so here is the webpage on psoriatic arthritis. they say that it can be asyymetric. but the key is that most if not all patients
with psoriatic arthritis have a history of psoriasis, on average 7 years before the arthritis starts, so I think this is out
so you don't have hot and swollen joints in the morning right?
that's good. Nope.
and you don't have any skin lesions like lupus stuff, correct
a little dry patch on my eyelid and that's it
so we are getting back to maybe an old trauma or
osteo just starting
eyelids are ok
I would wait it out, is your finger sore?
do you know about Voltaren gel?
occasionally, but mild. I was mostly worried about the association between erosions and rheumatologic conditions. I'm glad to hear the two are not exclusively associated. Never heard of voltaren gel
severe only if i've boxed. so I have stopped that activity.
voltaren is a gel that gets thru the skin , it is like motrin but better, it will relieve inflammation in the joint you rub it on and it helps
that's good. maybe i'll give it a try next time i have soreness.
well you don't expect bony erosions with RA until it is really bad. and you would have hot and swollen. I guess PA is a possiblitiy but very unlikely, and osteo could be starting but you don't need a rheum for that.
I would watch it for a few months, if other joints get involved , then you will have to get it checked
ok thanks for your help and insight.
sure, please rate me if you are satisfied ok?
Dr Frank T come back anytime
General Adult Neurologist. Board Certified. Experimental Neuroimaging and Neurodiagnostics
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