Osteoarthritis?

X-rays ought to reveal joint damage and depletion of cartilage caused by OA. Ultrasound will tell you what the lumps are. I went to bed one night and woke up next morning with one paralysed hand and severe pain in arms and wrists. I was doing everything with my left hand. Then, two weeks later, the same happened to the left hand though the right improved slightly largely on account of extensive exercising. I then developed nodes on my middle finger joint, end finger joint, wrists, elbow. A consultant said these were gout topi, without doing any tests, the GP said they were "nothing", I thought they might be rheumatoid nodules. An ultrasound showed a hugely inflamed tendon and the middle finger "topi" was a piece of tendon that had popped out of the sheath. The other "topi" was a piece of bone. The wrist "topi" were soft swellings. But they all looked the same. There was inflammation in the suprasinatus shoulder tendon which the consultant had said was a postural issue and referred me to an expensive physio. My own physio said if I had gout she would eat her hat and that it was RA.

Also, I would expect that at 18 the inflammation markers would be normal. Mine were normal - I was going to the gym every day and I eat a very healthy diet which reduces inflammation. I went on a cruise, drank heavily every night, did not go to the gym or swim, sat around and hey presto the inflammatory markers were abnormal. Started exercising again and stopped drinking and hey presto they were normal.

All this was preceded by a stingingly painful big toe nail and swollen big toe with a red rash that later developed large scales, plus exceedingly high uric acid levels. There are specific tests for gout but I have never had them. I had the medication and it made no difference. I am prone to thrush which causes high uric acid, as does gout, and I am prone to rashes and in particular psoriasis.

The point I am trying to demonstrate is that you cannot rely on blood tests or on just observation and you need to get proper investigations done on your hands. I have a friend in her 60s who has OA in her hands and she has cortisone injections for the pain but they are not stiff in any way. I think the diagnosing in this country is almost laughable.

Please insist that you get a referral to a rheumatologist and good luck. If you really find that impossible, then go yourself to see a physiotherapist. They are very knowledgeable about musculo skeletal issues and can arrange some of these tests. Don't be disheartened at the state of your hands. There's a lot of new remedies even for OA.