Consultant told me you don't get RA in your top knuckle. Do you know any different?

[MaureenMLove]

I've got RA, there's no doubt about that. Been on medication since December and everything going OK as can be expected.

At every appointment, when she's felt all my joints, I've mentioned that the top knuckle on my index finger is always sore. She said you don't get RA in that knuckle, it's more likely to be OA.

Today, I've noticed that it's very swollen and sore. I was seeing her every month, but she's transferred medication care to my GP now, so not seeing her until September.

She did say, any problems give me a call. What do you think? Has anyone with RA any better knowledge than me? I'm still new (and very fed up!) of this. Shall I ring her. Seems pointless if I'm stuck with it anyway. It's not going to go away and it'll still be the same in September.

Here's my finger. I'd take a comparison with the other finger, but you've no idea how difficult that is when there's no one else in the house to hold the iPad!

The top knuckles, as what you show in your photo, in your fingers are the distal interphalangeal (DIP) joints. Now, your consultant is correct that most often DIP joints get swollen from osteoarthritis, not rheumatoid arthritis. However, that is MOST OFTEN. It is not impossible to have RA in that joint, just less likely than OA.

The biggest question is figuring out if it’s RA or OA. OA joints are often hard and may develop bony nodules (these are called Heberden’s nodes). If the swelling is softer when you press on it, this may be more in favor of it being an RA joint problem, though it could still be OA going through an inflammatory phase. Certain imaging tests may help with differentiation.

But just based on a very “unprofessional” opinion of seeing one photo in bad lighting, the joint does seem possibly red and inflamed, and I don’t see clear bony nodules, which means it MIGHT be RA. Only you know for certain, though, how similar it is to your other joints that experience RA symptoms. Maybe tell your GP the consultant said it’s OA so you’d like an imaging test done to see how much damage there is since it’s causing you pain - if there’s no OA-type damage, this could also mean it’s RA.

Good luck and so sorry you’re experiencing this. Hope one of these might help.

Ah thank you. A very precise and informative reply. .

It's hard and feels bruised, so probably more likely to be OA. I think I'm going to give her a call tomorrow and get an appointment anyway. My toes are starting to spread when relaxed too, iykwim. I mean, where my resting foot my toes were touching each other, now there is a definite gap between a couple of the toes.

I really need to get some sandals that protect and support my feet to wear. I'm getting concerned that come September, when the weather turns, I'm not going to have anything that fits, because I've been wearing flip flops for weeks.

Starting to get fed up of this damn disease now. I love my shoes.