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What Causes Swelling, Stiffness And Purple Discoloration In Fingers?

Posted on Thu, 16 Jun 2016

Question: I've been having trouble with my fingers. Few of them have been swelling, sensitive and slight purple. Stiffness dosent just go away and not the same fingers on both hands. Not so much pain. But they have changed a little in shape. I've had rh, Ana,anti ccp, sed rate, and c reactive protien blood work done and everything is normal. My doc said I may have a gluten reaction but I've been gluten free for almost 3 months. But there is no change, in fact progression. I know there is no chance of injury. What can this be?? Also thought It may be ra but I don't have any other symptoms but in my fingers. No slight fever, not feeling tired or I'll. I understand there's a chance of seronegative ra, but some of the blood work would of shown something. No issues in family history w ra, and now I'm a gluten free vegan with a normal cbc blood test. What's going on?? Btw, 35 female

Answered by Dr. Naval Mendiratta (1 hour later)

Brief Answer:
Hand color changes

Detailed Answer:
Good evening

Thank you for writing on health care magic

Well, the color change and finger shape change with normal arthritis test is difficult to predict...I would like to know a few more details before guiding you further..

1. the color change Is on exposure to cold or as it is?

2. If you could attach pictures of the hands it would be helpful

3. any symptoms of dry eyes or dry mouth or hair fall or oral ulcers

4/ do your feet also change colors or is it only the hand..?

Do let me know these queries

Regards
Dr Naval.

Above answer was peer-reviewed by : Dr. Deepak

Follow up: Dr. Naval Mendiratta (12 hours later)

The color comes and goes without change in temp. My feet are ok, no dry eye or mouth and no oral ulcers. Some hair breakage due to processing. But not extreme. My knuckles used to be very sensitive but that has subsided. My pointer fingers seem to be curving towards my middle finger by the knucle under my nail. Also on my right hand I had a mushy bump that my doc said it was a cyst. In 3 years it never went away. I've also felt hard little bumps around my right pointer. Those have slightly shrunk. I would love to send a photo but it's not pasting in this area.

Answered by Dr. Naval Mendiratta (22 hours later)

Brief Answer:
Further course

Detailed Answer:
Good evening

Sorry for the late reply.. Had a long duty ...

As of now, it looks more of a deforming thing going on than any inflammatory arthritis. It is a bit tough to say what exactly is happening without the pics. These sort of changes can happen with psoriatic arthritis or Osteoarthritis. We should sort it out and see if there is something we can do to prevent it from happening further:

I would suggest you a couple of tests:

1. X ray of both hands( AP view)
2. Musculoskeltal ultrasound of the hand( that would pick up an inflammatory signals as well or if it an erosive osteoarthritis)

PS: Check the pics of Bouchards nodes/Herbedens nodes on net and do let me know if your hands are going that way...

Regards
Dr Naval

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naval Mendiratta (2 hours later)

I have uploaded pics. Plz let me know what you think. Also are there any other blood test that can completely rule out ra besides the ones I've had? And with the other arthritis would some come up in my blood work? I just don't want to be one of those seronegative cases in case it is RA

It looks like a very mild case of the nodes you mentioned.

Answered by Dr. Naval Mendiratta (15 hours later)

Brief Answer:
Probable Osteoarthritis

Detailed Answer:
Good evening

Thanx for uploading the images. Well these do look like Herbedens nodes...Goes more in favor of osteoarthritis. Dont worry, it wont damage the joint but yes cosmetically it can cause a bit of problem. It is a non inflammatory condition, hence all your blood tests are normal. But just incase you want to confirm, ultrasound of the hands would be the best choice as it will detect any inflammation going on which will not be picked by simple blood tests

But my diagnosis would be Nodal Osteoarthritis. It will stop itself in due course of time...But yes can be painful if something hits it or so.

I hope the information was useful. Do let me know for more queries. Would like to sort it out for you

Regards
Dr Naval

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naval Mendiratta (6 hours later)

But the nodes will go away?

Answered by Dr. Naval Mendiratta (1 hour later)

Brief Answer:
Hand Osteoarthritis

Detailed Answer:
Good evening

Well, sorry to say but they usually dont go away. They eventually stop. As I told you it wont cause much harm to your joints or damage them, but yes cosmetically they dont appear good.

And there is no treatment as such to make them go away or stop their progression. Medicines like Hyauloronic acid/Glucosamine can delay their progression but cant prevent it...Little bit of genetic component is there..( not sure if any of your family members have knee issues at older age). But for some reason, it has happened early at your age.

Bt yes I still suggest you to get an ultrasound of the hands done, to be sure it is not inflammatory arthritis..Since I havnt examined you so far...That would conclude our diagnosis

Do let me know for more queries

Regards
Dr Naval

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Naval Mendiratta (29 hours later)

No one in my family has nodal osetoarthritis. (Going back to my grandparents). So gluten wouldn't cause this? I do have family member with celiacs and gluten intolerance. I've been gluten free for 2 months. The tenderness went away but I'm noticing the bumps as you saw in the pic. If this was a cause of gluten how long would it take my body to repair it self? But if it is nodal osteoarthritis why is this speeding so fast? I've notice more lil bumps on other fingers. I thought it was a slow degenerative disease. I will be having ex rays regardless. Also, I don't have any grinding sounds or feelings when I move my fingers.

Also noticed some swelling in 2 fingers between the first and second joint. The lil bumps and swelling occurred within 1 day.

Answered by Dr. Naval Mendiratta (17 hours later)

Brief Answer:
Nodal Osteoarthritis

Detailed Answer:
Good evening

Well, the arthritis associated with celiac disease( Gluten) is very different. It involves the big joints and they are usually swollen tender. This sort of involvement of the DIP joints( Distal ones) is seen in only 2-3 conditions--> One of them is osteoarthritis, other is psoriatic arthritis and the 3rd one is sarcodiosis. I doubt you have the last 2 conditions as there would be more symptoms associated with it.

Nodal Osteoarthritis may not be running in the family , but still can be seen. Initially the spread is usually fast..like you will notice it in 2-3 fingers but then over time it slows down and the further growth stops. Grinding sound is seen in the knees mostly, not in the fingers.

Well, I may be wrong here as I havnt examined you personally. But from the history and the pics it looks more of Osteoarthritis only. X Ray and ultrasound would confirm our diagnosis. I would suggest you get it at the earliest if it is involving the other fingers too.

Do let me know for more queries

REgards
Dr naval

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Naval Mendiratta (17 minutes later)

Even if these joints were never swollen, in pain,felt worm or were red? Also I take care of stray cats. Would Ickes or flees cause this! (Allergic reaction)

Answered by Dr. Naval Mendiratta (10 hours later)

Brief Answer:
Further course

Detailed Answer:
Good evening

I have the recent images. I still feel it is osteoarthritis.

I didnt understand your first line, but osteoarthritis the joints are mostly cold. Rarely you feel them warm to touch or red in appearance. Those are the signs of inflammatory disease rather than degenerative disease. One way we distinguish it on examination.

As for Allergic reaction, it would be more symmetrical and spread all over since it is a reaction of your body to a foreign subject. So, you wont expect it to be localized to one or 2 joints. The symptoms would all appear at the same time. So less likely to be allergic

Do let me know for more queries

Regards
Dr naval

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Naval Mendiratta (2 days later)

So my X-rays came back completely normal. No arthritis or irregularitys. However he said I have a very mild case of osteopenia. And recommended vitamin d and calcium. He also said this may have cause my fingers to change in shape. As far as nodules he feels I don't have them. Can this cause the bumps on my fingers? And once I take the supplements will they go back to there regular shape? If so how long will it take?

Answered by Dr. Naval Mendiratta (20 hours later)

Brief Answer:
Further course

Detailed Answer:
GOod evening

Sorry for the delayed reply.

Err....I really doubt Osteopenia can cause these shape changes. Never the less, since your doctor has examined we can give it time..Either way they wont damage your joints or anything....You can take these supplements for 2-3 months and see if they revert back.

My opinion..They may not...But since he feels confident, no harm in trying...Are they gonna go ahead with Ultrasound of the hands as well??

REgards
Dr Nava

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar