Could this be a miss-diagnosis?

All the joints in my hands and wrists hurt, including shooting pains from my wrists and down my lower arms. I don't know if this is Carpel Tunnel syndrome? However, the painful joints in my hands are not inflamed and swollen like when I first got RA (I was extremely bad with it). I'm on methotrexate, which I seem to have responded to well and was on prednisolone for 2 to 3 years in the beginning. I am informed that painful DIP joints can't be RA - but all joints hurt and, initially, all the joints in my body. I'm now beginning to wonder if it's a miss-diagnosis - What else might it be - does anyone have any ideas??

4 Replies

  • I think RA causes swelling which can compress nerves which can lead to carpal tunnel. Wrist splints can help as they place wrist in a better position to free the nerves. However your gp or consultant would need to make proper diagnosis. I get swelling in wrist down from thumb which causes pain and pins and needle at times thank goodness it comes and goes so im lucky . I hope you get some answers soon- take care 🌸🌻🌸

  • RD can affect any joint, but typically (if there is such a thing) is said to affect the metocarpal-phalangeal joints. But the Arthritis Warrior blog, although from the States, explains very well that there isn't really a classical presentation or course of RD, as most of us do not have what is described in the textbooks (or online).

    So, yes, it could be RD, but could also be OA, which often affects the more distal joints.

    Probably the best way of finding out would be an ultra-sound scan, but that may not be easy to get. That would show up any inflammatory process in those joints.

  • I have RA and get shooting pains down my fingers so it could be the RA. For me it the pain seems a bit different in every joint. But the pains can be different in the same joint at different times. How you feel pain in a joint could feel very different to how someone else feels even with the same condition.

  • Hi AMc, I'm sorry I have abbreviated your name so that it's easier for me to say Hello. (You probably have a much better abbreviation so do let us know what it is - I'm sorry if that upsets you, certainly didn't mean to).

    Hand and wrist pain - and throbbing pain all the way up the arms sometime! I have it on both sides. And one of the things in my case is that all factors are conspiring together in this torture. An Xray of my shoulder revealed too little room for the nerves etc to pass through comfortably, but the shoulder op to make more room didn't ease the pain.

    The ultra sound I had on my knuckles showed that the joints were already becoming eroded. This was done as part of the diagnostic process for RA. (It didn't show up in the blood tests). My rheumatologist sent me for a nerve conduction study which showed carpel tunnel problems and also suggested that some pain was due to neck problems (My back specialist (disintegrating discs in lower back) had an MRI of whole back done but is waiting for a full spine Xray before ruling that out).

    An Xray of my hands showed osteoarthritis in the bar joints of my thumbs (sorry - base joints) - extra growths of bone and sseizing up of the joints. After trying 2 lots of steps injections in my thumbs (steroid injections) (works for a bit but not for long), I am having operations on my hands to remove a section of bone at the base of each of my thumbs and they will open the wrist and reduce the pressure on the nerves in the carpel tunnel area at the same time. As part of my journey I have discovered that some GPs have no idea of what survey is on offer these days (sorry - surgery! ) One of my GPs said 'What do you expect them to do for you? They can't give you a new wrist' I had to smile last week when my rheumatologist offered to do just that, if the worst came to the worst!

    Back to the point. - so pain in hands and arms could be

    shoulder - not in my case, neck - also probably not in my case, RA - contributing as small joints are almost certainly eroded and inflammation will put pressure on all sorts of nerves, OA - very probably as bones change with age.

    How to find out

    You should at the very least have an Xray done and kick up a fuss of you haven't been sent for one.

    Diagnostic ultrasound will help, if it's available and could pinpoint the joints involved in case that is the cause.

    Am orthopedic hand surgeon should have expertise in all sorts of hand problems and you probably should be referred to one. In fact you can ask to be referred to one. If you live anywhere near Crewe, I can recommend a very good one. :-)

    It's best not to put everything down to R A and explore other avenues as well.

    Hope you have some relief and clarity soon.


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