Osteoarthritis?

[Lilynette]

Ive been ruled out for RA in blood test but my hands are bad, their always stiff no matter what and weak with increase in pain when i try to do activities. Im 18, my left hand has a bone spur i think on the right side of my middle knuckle and tendons that slide off bad. My knuckles always crack even the ones close to my fingernails and on my right hand middle finger near the fingertip i think i have a heberdens node forming and its scaring me. I need surgery bad i know i do but why me so young Im only 18

[DelicateInput]

Blood tests cannot confirm or rule out RA.

[Lilynette in reply to DelicateInput]

I know that but i believe my symptoms point more towards OA considering my problem is mainly in my hands and my left hand is worse than my right

[DelicateInput in reply to Lilynette]

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.

[Lilynette in reply to DelicateInput]

Thank you so much for the reply and information i am having trouble getting to a rheumatologist bc of my insurance and my other doctors only did one x-ray on my left hand but it wasn't as bad when they did, compared to now. And many of them are so low educated on this i think. Its kind of frustrating bc i need a job to save up for college but im scared to damage my joints or when i have surgery my job might just fire me bc i believe I'll need surgery soon the bone is only progressing further

[DelicateInput in reply to Lilynette]

I hadn't realised that you are not in the UK so have different medical options. It does seem a bit stupid to x-ray only one hand. You can just as easily put both hands on the x-ray glass as one hand, and then later zoom in on the film to see the fine details of the bones in the hands.

An MRI would possibly be only done on one hand - you have to lie face down in the scanner for an hour with your hand raised and it is excrutiatingly uncomfortable, and with a frozen shoulder almost unbearable. Ultrasound is very good and shows up everything from fluid to erosions, synovitis and synovial thickening, vascularity so I think the better option. It is also much cheaper than an MRI. Both hands are done separately and you can see the images coming up on the screen, with the sonographer telling you what they can see.

If you were living in the UK, I could suggest a few possibilities but I am afraid I really don't know what to advise. I feel that if they can't even work out how to do an x-ray or better imaging, I would not feel confident about having surgery.

Do you think, if you have OA, that it was initially precipitated or caused by RA, as seems to be the case for a lot of people on here, or have they even considered that?

Best wishes and I hope you get some satisfaction soon.

[Hidden]

Do you live in the US? I don't know alot about US guidelines, but I do have some knowledge. I live in Canada very close to the US boarder and I have family living in Seattle

I just thought I'd include a couple of possible resources that might help.

If you don"t have any insurance, try

Find a Health Center from the HRSA. These Federally-funded health centers care for you, even if you have no health insurance. You pay what you can afford, based on your income.

Also, check out these sites for the location of state and regional Free Clinics, and NeedyMed"s Free and Low-Cost Clinics which may have something in your area to help .

I wish you well

Sue