Apparently it's not inflammation, so wtf is it?

[Cronehands]

I've had vaguely painful finger joints for a while. They do not like the cold.

Before Xmas, the middle finger joints swelled up for a few weeks. They hurt to touch and would get really itchy at night. I also developed little lumps either side.

I have reynauds and psoriasis. Hayfever. Some hypermobility. Fit, active, not overweight. Ill about once a year, but on second bout of covid.

Dr sent for bloods, to rule out psoriatic arthritis. Came back clear.

But the left hand is now starting and I have a lump on the middle joint of middle finger.

Where do I go from here?

X-ray for osteoarthritis? That’s how mine started, X-ray -then ultrasound- to diagnose it.

Yep. Had an xray 2 weeks ago, but heard nothing since.

Have you phoned the GP to ask for your X-ray results?

Our radiology dept always says ‘phone your GP for your results in 10-14 days’.

GP’s don’t routinely contact every patient with results, unless urgent, because they have hundreds of blood test results, ECG/X-ray/24 hr BP reports to review each week. If they contacted each patient there wouldn’t be any appointments at all!

I work in a GP surgery

Chilblains

Came on to say it could be ulcerated chilblains, but it really doesn't look like that. Are they painful?

Sorry I see you say the lumps hurt to touch. Maybe that sounds like standard chilblains. They don't look very red or inflamed. Do you take nifedipine?

@Cronehands why did they think psoriatic arthritis rather than rheumatoid?

In my experience inflammation is sometimes difficult to pick up with bloods especially with a condition that flares.

I have scleritis and have had painful movable lumps on elbows, painful patches on knees, hands that can't open jars but blood tests were all normal. I also have a history of autoimmune diseases.

You have my sympathy

Ask to see the blood test results.

Check to see if they did CRP levels and have a look to see if they are in normal range.

And x ray results should now be due so you'll see whether it is osteo.

It's a pig when you don't know. I've got a few crappy diagnoses but it's the 'don't quite know' ones that piss me off

Psoriatic arthritis is usually seronegative, so won't show up inflammation on blood tests. Also tends to start in finger joints. I'd be pushing for a rheumatology referral, particularly as you already have a psoriasis diagnosis.

Yes, had psoriasis since I was about 12. It's on my dad's side. I also have gum trouble. That's why they queried psoriatic arthritis.

Think they did crp levels, but will ask next time. I haven't been to a Dr for anything requiring more than antibiotics in the last 10 years, so no real idea where it goes next.

They don't go red, but all sausage like when I wake up. When they go itchy, they can get a bit mottled. My second toe can do the same, but I put that down to running.

Psoriasis here . Had severe flare up post birth wit infection complications. Sudden onset of severe pain in joints all over . Dermatology referred me to rheumatology . At the appt a quick ultrasound scan of fingers confirmed arithitus (psoriatic) commenced on 90mg of etoricoxib a day. Push for the referral

I've not actually seen a physical Dr yet; this has all been via online and phone consultation. Think she's waiting to see the x Ray.

I've had psoriasis for twenty years, most of that time it's been very mild and not bothered me. Then last year my ankle and finger joints got very painful, with some swelling. Saw a rheumatologist, diagnosed with psoriatic arthritis, and now on methotrexate which will stop it progressing as fast. The Psoriasis and Psoriatic Arthritis Association has lots of good information. My GP didn't seem to be aware that psoriatic arthritis doesn't tend to show up in blood tests - I'd push for the rheumatology referral. Rheumatologist said there's unlikely to be anything visible on a standard X ray unless there was bone damage which there'd only be if it were left untreated for several years, so although I'd had X rays he wasn't particularly bothered about seeing them!

I just don't want to be that person who turns up with Dr Google and tells the Dr how to do her job. Everything I've read points to psoriatic arthritis. I'm early 40s, bags of energy in spite of busy job, kids etc. Just have these stupid joints.

You shouldn't worry about being the person who turns up with Dr Google

I have masses of health problems. It's been an awfully bumpy ride for me for the last 4 years or so. But I've fought and advocated for myself to be diagnosed and treated correctly.

What I found best was printing something off from the NHS site itself. Or actual medical organisation / charity such as arthritis UK. You only need to pull out your paperwork if need be. Or if you're dismissed you can gently say "I see Arthritis UK / NHS guidelines state that Psoriatic Arthritis doesn't usually show up in bloods and should be diagnosed clinically" believe me, they usually sit up and take notice.

But hopefully you won't need to. I hope you get to see a good Rheumatologist. Makes the world of difference.

I think I need to actually see someone face to face too. Doing everything online and via snatched phonecalls is quite tricky.

I was painting yesterday and my 2 right fingers are a bit sausagey this morning, so it's also aggravated by gripping. My first flare up was following a slightly terrifying 3 hour car journey, where I was gripping the steering wheel the whole time.