Deformity or not? : So I believe that the middle... - NRAS


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Deformity or not?

fizzierascal profile image

So I believe that the middle knuckle on my middle finger is starting to get a bony deformity .... it’s where my pain started and where it’s generally worse also (my Mum says if I hadn’t spent so many teenage years giving people the finger I wouldn’t have a problem). I don’t have a diagnosis and am due back at the GP in December for more blood tests to see if my vit d and calcium levels are more normal. But I think this joint is changing and you can feel on one side where it goes in and on the other side where it is sticking out. I guess my question is ... is it worth another trip to the GP to request another X-ray and be made to feel like I’m making it up again!?

Thanks in advance x

9 Replies

I can't really tell from the picture, but you will know better, because it is your body. I believe that if you think something is not feeling right, you should definitely get it checked.

I have 2 kinds of deformities on my fingers. Some have what's called a swan neck, and some have the boutonniere kind. I am wearing finger splints for these.

Swan neck is when your finger is hyperextended at rest, and boutonniere is the opposite where you can't extend your finger. You'll find pictures on the internet for both.

Thank you

As you had an X-ray quite recently, iirc, it would be unusual for something to change so rapidly.

How are you getting on with the vitamin D and calcium supplementation? Are your joints feeling any better with these supplements?

Over time, depending on what happens with your vitamin D and calcium, your GP might be intending to assess you for hypOparathyroidism. It's very unusual (particularly in the absence of surgery that might have damaged the parathyroids) but it's a good thing to rule out as well as hyperparathyroidism in the case of musculoskeletal pain that doesn't have another clear diagnosis.

"Hypoparathyroidism is the state of decreased secretion or activity of parathyroid hormone (PTH). This leads to decreased blood levels of calcium (hypocalcemia) and increased levels of blood phosphorus (hyperphosphatemia)."

I have less consistent pain with the calcium and vit d ... bit I’ve noticed that just before it starts to really hurt I get ever so hot! It may not be related. The pain has spread to my wrists more often and my elbows occasionally I’ve noticed.

I’ve also noticed that on a couple of finger joints when I use them in certain positions I get a feeling that’s hard to describe but it feels like the joints are rubbing against each other. This immediately stops when I put my fingers into a better position.

Do you recall what your vitamin D and calcium results were and how much you're now supplementing, if I might ask?

It's not unusual to have some bone pain if you're supplementing vitamin D because greater uptake of minerals by the bones causes part of the structure to swell a little against the comparatively less-flexible periosteal outer structure.

I can’t recall exactly but this may hopefully be the reason why. Thank you x

It's only a couple of months since your last x-rays? And I think your GP is still sitting on the fence about a diagnosis? So not sure that another X-ray would make any difference? It doesn't look as if the knuckle is hot or swollen to me? So if X-ray shows no changes then you are no closer to a diagnosis, and if it does show changes the likelihood is that GP will just put it down to osteoarthritis.

If you don't have any antibodies in your blood, or raised inflammation markers then the road to a precise diagnosis can be slow & hard. Do you keep a daily pain diary so you can tell the GP specifically what hurts and when? And if your joints do swell, take a photo!

The other thing is to check what antibody tests the GP did. It's possible that they only did the RF test (rheumatoid factor). If so you need to ask them to do the anti-CCP test which is moRe sensitive.

They didn’t do the anti CCP and I hadn’t thought of the pain diary. Thank you. I’ve had a week of no really massive pain so no swellings or anything at the moment x

There's nothing obvious I can see but it's not easy to tell from a pic. It certainly doesn't look red, that would show if there's inflammation of note. My deformities are more obvious, & painful but they're generally OA related not RD. As you had an X-ray recently I'm not sure one would be ordered again, unless your GP examines the finger & determines it necessary.

I'm afraid if inflammation blood tests don't show anything of note you wouldn't be referred, unless you start to get joint pain elsewhere, especially if it's bilateral, & on examination your GP is convinced there's something definitive going on then they would be reordered & you'll be reviewed.

I'm afraid for the mo it may be a case of waiting. Maybe applying something like Pernaton gel would be helpful for the times you feel the pain worsening.

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