Doctors cannot find cause | Arthritis Information

Share
 

For six months my wife, age 56, has had swollen joints on the fingers of her left hand; the thumb is not involved.  (She is right handed.) This condition came upon her suddenly with no previous episodes. Her fingers do not hurt unless she hits her hand or puts pressure on the fingers. Her fingers have lost most of their flexibility. The doctors believe it is osteoarthritis, but her hand has not responded to any treatment to reduce the swelling and inflammation. Since January, she has taken four different NSAIDs and two prescriptions of Prednisone for inflammation, has had two shots in the joints of her fingers, and ten weeks of occupational therapy.  Nothing is working.  She has had blood tests to rule out rheumatoid arthritis, Lyme disease, gout, and infection (SEDrate).  The doctors would welcome another opinion as they do not know what to do at this point.  Where do we go from here?  Boston, NYC, and Hartford are accessible to us. Are there other links you would suggest?

Hosea,

Take a look at the forum on Rheumatoid arthritis. You will find a lot of answers there. It sounds like that is what your wife has it even if it isn't showing up in the blood work.

Has she been to a rheumatologist or just a general practioner? The rheumatologist is the one that can treat her best. It is not uncommon for people to have this disease for a long time before it shows up in the blood work.

As far as links: www.arthritis.org is the Arthritis Foundation. http://health.nih.gov/result.asp/565 is the National Institute of Health. www.about.com has general information. 

Let us know how things turn out. She needs better doctors.

Hi Hosea,

There is no test that can rule out gout.  Her blood uric acid level can be normal (4.5~7.0 mg/dl).  That doesn't mean she can't have gout.  About 50% of gout patients have normal blood uric acid level during the gout attacks because the kidneys excrete more uric acid during the gout attacks. Considering the fact that her symptoms occurred suddenly and in the left hand only, there is a possibility of gout.  Also, not all gout patients respond to nsaids and prednisone.  Some of my  suggestions are:

1)  See a rheumatologist.
2)  Have an x-ray to rule out the possibility of osteoarthritis.
3)  Try (Rx) colchicine which is gout specific.  If she responds to colchicine it's most likely she has gout.
4)  Test the problem joint fluid for monosodium urate crystals.  If the test finds msu crystals, she has gout.  Sometimes the crystals are there but may take repeated tests to find them.
5)  See a neurologist and have an electromyography to test the possibility of nerve compression such as carpal tunnel syndrome.

Was she on medication before the symptoms showed up?  Some medicines such as diuretics can trigger gout attacks.  Good luck.

JYY138857.9712037037Has your wife ever had psoriasis?  Could be psoriatic arthritis.
Copyright ArthritisInsight.com