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Old 12-08-2012, 07:23 PM   #1
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I'm being referred to a Rheumatologist . . .

I'm coming to my JBs because you all are so darned smart and well-read! Have any of you had experience with rheumatoid arthritis, or any other types of systemic arthritis?

It's early yet, as I don't have a diagnosis, and it may be nothing at all, but I was referred on Friday to a Rheumatologist. I don't have my appointment yet.

Back story: A few weeks ago I had a minor papercut. It was fine for a few days, then I experienced swelling and redness. I gave it a week or so, treating for infection at home, but nothing helped. I went to my GP, and he said it looked infected too, but ran bloodwork for arthritis and gout as well (I do have the condition which causes gout, but mine presents with kidney stones). By the time I saw the doctor, I had a similar inflammation on my right pinky (see pictures), but had not cut myself there.

My GP prescribed antibiotics and I took the whole round with no improvement. On Thursday night, the other two fingers were worse than they were when I saw the doctor about a week and a half prior. Then, Friday morning, I also noticed the same thing happening to my right middle finger. So I went back to the doctor, he reviewed my bloodwork and told me everything was perfect. Now he's sending me to the specialist because he has no idea what's going on.

I'm fine, I feel great other than these silly fingers, but just thought you all might have suggestions or references for me to check out. Oh, one other thing; I have mild Psoriasis and I also was wondering about Psoriatic Arthritis, since it's not presenting in a symmetrical fashion.

TIA, best BUDDDs!

ETA: The pictures don't really do it justice. They are both hard and the ring finger is so swollen I can't bend my finger (it's also a weird mottled purplish color now). The new one, on my right middle finger is on the palm side and like a hard bubble, similar to a ganglion cyst.
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Old 12-08-2012, 07:47 PM   #2
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ouch! I have no helpful knowledge, but just want to say I'm sorry about it and hope they figure it out soon!
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Old 12-08-2012, 07:47 PM   #3
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Lordy, Girl! I can't imagine what this could be. My ex had rheumatoid arthritis, but never anything that looked like that. I'll be glad when the rheumatologist can see those fingers and see if s/he can identify the problem.

The only reason I was referred to my rheumatologist was when he diagnosed (finally) why I had so much pain, which was fibromyalgia. And I have plain old osteoarthritis, which runs in my family anyway, so I always expected I would get it like daddy and his mother did.

That even looks sore in the pictures. HOW SOON is your appointment with the specialist???
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Old 12-08-2012, 07:57 PM   #4
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Dawn, You have the prettiest nails that I have seen in a while. Mine are short and well, not so pretty.

I am concerned that there is a possibility that you could have psoriasis or rheumotoid arthritis? Does this run in your family? My father had Psoriatic Arthritis and his aunt had quite a case of rheumotoid arthritis that I have ever known.

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Old 12-08-2012, 07:59 PM   #5
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I am so sorry you are experiencing this. It looks very painful and I hope you find out what it is and can get relief.

I was diagnosed with RA over 15 years ago but never had fingers that looked like that. I had DNA testing done also to see if I had the worst variety which I do not. If I control my diet, I have no symptoms but it took awhile to figure out what kind of set it off. Rarely have an episode anymore.
My fingers hurt just looking at your pictures. Hugs.
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Old 12-08-2012, 08:01 PM   #6
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My father had very emphasized white scaley elbows and knuckles. Just thought I would share, because I am thinking this is NOT what you have.
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Old 12-08-2012, 08:29 PM   #7
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Sorry you are going through this, Dawn. Hope it clears up soon!
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Old 12-08-2012, 08:32 PM   #8
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Are you in pain? How much, ona scale of 1-10
If yes for pain, how long does it last?
Have you had x-rays?
Are the bumps nodules? Hard cysts? Malleable cysts?
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Old 12-08-2012, 08:32 PM   #9
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I am not a doctor, but that looks more like the start of cellulitis to me. Psoriasis can make you more prone to cellulitis also. The antibotics they gave might not have been strong enough and you were a bit resistant. They usually give cephalexin for it, which is just a wick, wick drug...but works.

My client just had cellulitis a few months back, and I know I had to fight his GP about it. He said it was his brace rubbing. I said no it wasnt (I was marking the spreading red area with a marker). They ran blood work, I was right.

I would make the appointment, and see what the Rheumatologist says. But I would ask about his thoughts on Cellulitis too, only because left untreated can lead to MRSA which is something you really dont want to deal with!! Cellulitis is a bacterial thing, and spreads in your blood, which is why it could of popped up in your other hand also. Just my thoughts!
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Old 12-08-2012, 08:35 PM   #10
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Not one of the expert JUDDD buds here but could it be your gout flaring up in your fingers? DH has gout and it might look like that if it was in his fingers instead of toe joints. You do have beautiful hands, wish my nails would grow out like yours. Hope the issue clears up quickly and you find the cause. Doesn't rheumatoid arthritis show up in the exact same joint on both sides?
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Old 12-08-2012, 09:14 PM   #11
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Wondering about the infected paper cut......Hopefully, the specialist appt is soon otherwise I'd ask for a redo on the labs since something might show up now that didn't previously.
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Old 12-08-2012, 10:09 PM   #12
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ACK! that looks like owies to me! (((HUGS))) Hope you get answers soon!
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Old 12-08-2012, 11:08 PM   #13
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Good Lord, that looks painful!! My Mother has rheumatoid arthritis & I've not seen anything that looks like that. Her fingers are so crooked from years of sewing & quilting. My son has gout; but, his is in his feet & ankles. I've not seen him when he has a flare up tho. So I can't say what it looks like.

I hope you get some answers soon! Sorry I couldn't help.
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Old 12-09-2012, 01:50 AM   #14
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A second vote for Cellulitis, my son had it a few years ago, and when he gets run down it appears in a lesser form. His is on his face
His seemed to be caused by a small cut also. As said needs to be kept an eye on as it turns in to other things.
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Old 12-09-2012, 03:09 AM   #15
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This is new territory for me, but I did some research and add my voice to Katiebubb's. I think her suggestions are a most excellent path to take - ASAP. If you are not scheduled to see the Rheumatologist for a long time (and we are talking days, not weeks) go talk to your doctor about Cellulitis.

I also add my cheers to the 'Dawn, you have gorgeous fingernails and your hands are as beautiful as you are!!!!" club.
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Old 12-09-2012, 04:29 AM   #16
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Dawn, I have no experience of cellulitis but I do know that gout affects toes in that way. If it's "only" gout, it's easy to sort with diet.

I hope you soon get it diagnosed and sorted.
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Old 12-09-2012, 05:31 AM   #17
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Good on your GP for the referral. It is worth looking at non-rheumatoid variants, particularly with the details of this incident and your psoriatic history. Many, many of these resolve on their own - good to keep your thoughts aimed in this direction - but further testing is smart. You'll know if any rapid progression - local or systemic - warrants emergency care. Just my two cents. All the best.
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Old 12-09-2012, 06:21 AM   #18
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Quote:
Originally Posted by Katiebubb View Post
I am not a doctor, but that looks more like the start of cellulitis to me. Psoriasis can make you more prone to cellulitis also. The antibotics they gave might not have been strong enough and you were a bit resistant. They usually give cephalexin for it, which is just a wick, wick drug...but works.

My client just had cellulitis a few months back, and I know I had to fight his GP about it. He said it was his brace rubbing. I said no it wasnt (I was marking the spreading red area with a marker). They ran blood work, I was right.

I would make the appointment, and see what the Rheumatologist says. But I would ask about his thoughts on Cellulitis too, only because left untreated can lead to MRSA which is something you really dont want to deal with!! Cellulitis is a bacterial thing, and spreads in your blood, which is why it could of popped up in your other hand also. Just my thoughts!
I hadn't thought about cellulitis. Since my labs all came back great (and he did a sed rate for infection) I thought maybe it wasn't anything like that. I'll call him tomorrow and see what he says.


Quote:
Originally Posted by DairyQueen View Post
Are you in pain? How much, ona scale of 1-10
If yes for pain, how long does it last?
Have you had x-rays?
Are the bumps nodules? Hard cysts? Malleable cysts?
Pain is sort of a weird concept with me. I am in pain, but I have a very high tolerance. I broke my elbow and never sought treatment when I was a teenager (I can feel the crack, and have since confirmed I broke it). I had a bad skiing accident when I was twenty and it took me 3 months to seek treatment. It turns out I had chipped bones in my hip joint. So take this with a grain of salt.

I have constant pain, but it's minor. More of an annoyance most of the time. Sometimes it hurts significantly more and I feel like I could cry. That's a 10 for me, and lasts maybe 10-20 minutes a few times a day, but mostly it's at a 4 or 5. I have not had xrays yet. The two bumps on my right hand are both round. One is hard and set, the other feels malleable. The left ring finger is just a big old swollen mess. It's hard, but not bony hard. It's swollen enough that the skin is stretched tight.

Quote:
Originally Posted by sunday View Post
My father had very emphasized white scaley elbows and knuckles. Just thought I would share, because I am thinking this is NOT what you have.
I get minor patches on one elbow, the crease by my nostrils, my eyebrows, and hairline.

Quote:
Originally Posted by sunday View Post
Dawn, You have the prettiest nails that I have seen in a while. Mine are short and well, not so pretty.

I am concerned that there is a possibility that you could have psoriasis or rheumotoid arthritis? Does this run in your family? My father had Psoriatic Arthritis and his aunt had quite a case of rheumotoid arthritis that I have ever known.
Thank you for nails comment. They're wasted on me. I hardly ever even put on nailpolish. Literally maybe once a year.

My grandmother had arthritis, but I never thought to ask what type. Her hands were very gnarled. I don't have a "known" history of rheumatoid arthritis, but I have a couple of other autoimmune conditions, so I am concerned about it, especially if my grandmother did have it.

As for the gout, that was honestly my first thought, since I have an excess of uric acid. My labs came back great, but I'm also not ruling that out.

I have not heard back with an appointment date yet, so I will be hounding the doctor tomorrow.

Thank you all so much for your replies. I knew my JBs would have ideas!!
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Old 12-09-2012, 06:58 AM   #19
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Dawn, I agree with everyone that you have beautiful hands. Even swollen. You've gotten a lot of good advice, especially from Katie about the cellulitis. The only other thing I can think of is staph. That doesn't seem likely since it is now affecting your other hand, but could the infection have spread? I'm no doctor, but I play one on the internet.
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Old 12-09-2012, 07:06 AM   #20
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hey,'im a medical student (still a few years to graduation yet tho!) and like you said with your history of autoimmune diseases, it does make you more prone to others such as RA. Luckily RA has become a lot more managable in recent years with drug therapy. From the pictures i cant tell either way what it is tho. Hope all ends up ok!
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Old 12-09-2012, 07:33 AM   #21
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Lurker here... My husband had gout and RA and suffered terribly for many years. Over the long term, with gout, you get tophi. Tophi look like white blobs under the skin around joints. They
can become pretty large. He had one that was almost the size of a ping pong ball on one elbow (that had been injured in a car accident and the tophi built up in the ruptured bursa sack). I think they are uric acid deposits that build up over time (need to google that). There are meds to take while you are in the acute phase of gout that will get it under control. They are usually of the anti-inflammatory type. I think the one my husband took was called probenemid. Harsh on your stomache to say the least. There is also a medication they prescribe to keep it under control if you have constant flare ups with it, I think that was called allopurinol.
I hope you get an appointment soon and find out what it is. I know what misery both RA and gout can cause and wouldn't wish it on anyone.
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Old 12-09-2012, 08:11 AM   #22
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Dawn, I have psoriatic arthritis which is systemic like RA. I never had anything like that, but DW had cellulitis after a small cut and she ended up being hospitalized for 5 days after letting it go. Please call the doctor back tomorrow! Please feel better soon.
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Old 12-09-2012, 08:18 AM   #23
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I hadn't thought about cellulitis. Since my labs all came back great (and he did a sed rate for infection) I thought maybe it wasn't anything like that. I'll call him tomorrow and see what he says.
Its hard to tell from a picture and like I said I am not a doctor. My client's started from a broken arm. He fell in the basement when his wife was making dinner one day. We had a heck of a time getting that to heal. Because about 3 weeks later he fell in the bedroom and landed on that arm again. My client wanted to have surgery but his doc said no because its a "useless" arm (he had a stroke years ago). yada yada yada.......lol!

I hope you find out what is wrong! Its miserable until you know for sure!
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Old 12-09-2012, 08:31 AM   #24
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Hope you get sorted out soon - looks painful! I had cellulitis last year on my leg and looked quite similar - very red, swollen and painful. Definitely agree that it is good to rule it out since it can suddenly get worst. I felt very sick for a few days.

Good luck!
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Old 12-09-2012, 09:11 AM   #25
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I have nothing to compare it to anyone I know.
Does look sore!
I'm sure u've done the first aid route.
Haven't changed hand soap-dish soap- lotions?
Even laundry soap. We r always touching cloth.
Same as for at the work place. Change in anything ur touching??
So glad u got the Anti B running in your system fast.
Even getting those 100% white Cotton- light weight gloves.
U've seen them in the medicine area at Walkys or Walgreens maybe.
BEST wishes in fingering this out FAST!
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Old 12-09-2012, 10:31 AM   #26
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Cellulitis can land you in the hospital...there's also staph.

I am an RN and do not freak out about stuff and tend to treat at home, if possible, but in your case, I'd be paying close attention.

If the course continues, you should go to urgent care or the ER.

If the paper cut or any skin breakdown has occurred, they can culture.
They will also have seen more than a doctor's office and may recognise it immediately especially if they know it started from a cut......that alone should make them take notice.
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Old 12-09-2012, 10:37 AM   #27
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Cellulitis can land you in the hospital...there's also staph.

I am an RN and do not freak out about stuff and tend to treat at home, if possible, but in your case, I'd be paying close attention.

If the course continues, you should go to urgent care or the ER.

If the paper cut or any skin breakdown has occurred, they can culture.
They will also have seen more than a doctor's office and may recognise it immediately especially if they know it started from a cut......that alone should make them take notice.
I like this advice. I would do this if it doesn't get better quickly.
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Old 12-09-2012, 10:52 AM   #28
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Originally Posted by jem51 View Post
Cellulitis can land you in the hospital...there's also staph.

I am an RN and do not freak out about stuff and tend to treat at home, if possible, but in your case, I'd be paying close attention.

If the course continues, you should go to urgent care or the ER.

If the paper cut or any skin breakdown has occurred, they can culture.
They will also have seen more than a doctor's office and may recognise it immediately especially if they know it started from a cut......that alone should make them take notice.
So- yep, I agree with Jem and Katiebubb. My left arm had all the lymph nodes removed through the 2nd level (up to the clavicle) and they told me to be extremely careful of anything: paper cuts, insect bites, hang nails, cuticle cracks, burns etc. Because I don't have a functioning lymph system in the left arm, I'm at high risk for cellulitis and other infections.

I know it's different for you since you do have a functioning lymph, but as one of the posters mentioned, since you do have that history of AI disease, I would think that also puts you at higher risk for infections involving the lymphatic system - a big part of the immune system.

I think it looks like cellulitis. The lymphedema specialist told me that if that happened to me, I had to seek help within 24hours and mostly at the ER cuz a lymphatic infection can take over very quickly! She said cellulitis is a very bad infection and lands people in the hospital on IV antis all the time.

Since it is spreading to the adjacent finger, I would surely look at going to the ER. The only thing that is puzzling is the occurrence of it on the opposite hand which is a separate lymph region, although still connected.

It would be a very little inconvenience and cost of peace of mind. Don't just go to a minor emergency room either. You need people who KNOW what they are looking at and that only happens with busy ER rooms with good hospital labs behind them.

and sorry to scare.
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Old 12-09-2012, 10:52 AM   #29
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I hope it's nothing serious and is resolved quickly.
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Old 12-09-2012, 11:22 AM   #30
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Two years ago, I had something that looked very similar, but on several toes.

It was MRSA cellulitis, probably from an abrasion on one toe that became infected and then spread (MRSA is very contagious). I'm intolerant to most oral antibiotics, so I was given topical Bactroban. It cleared within a week.



I'm in agreement with Jem -- if no improvement (soon), I'd seek out another opinion. It may need to be cultured and have sensitivities run on it.
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