Trigger Finger: An Unusual Clue to Hashimoto’s Thyroiditis

[helvella]

Back to the old, old story. Rather than put Hashimoto's/autoimmune thyroid issues or - indeed - possibly hypothyroidism of any cause on the list of things to check, patients sometimes get to the point of actually having surgery. Even two operations.

It isn't clear to me what course would have been most likely had thyroid issues been identified and treated right at the first clinic appointment. Or - even more helpfully - by the referring GP.

And, obviously, at best surgery only fixes the thing that was operated on. Leaving any and all other issues likely unobserved, but certainly untreated (or in those with known thyroid issues, likely wrongly treated).

Some good, clear photos of the hand showing the effects of trigger finger on the hand.

Trigger Finger: An Unusual Clue to Hashimoto’s Thyroiditis

This case underscores the importance of considering underlying systemic conditions in patients with TF, particularly when presentations are atypical or refractory to standard treatments (including surgery).

Full short paper open access here:

europepmc.org/article/PMC/P...

There have been a number of posts about trigger finger. Although search is poor, this did find a number of relevant posts (and several which are not).

healthunlocked.com/thyroidu...

[Goldengirl01]

I have had trigger finger on my little finger twice, the first time the consultant at the hospital surprised me from behind and injected into the finger quickly which was probably the best way, the second time it wax done at my doctors by my Dr who was being taught by anothef Dr. Just my luck....Not. she was going very slowly with a long needle in the finger I nearly passed out never again I just put up with it.

[Thyroid17]

Slightly off topic but I was scheduled for carpal tunnel surgery which was cancelled as correct medication resolved the issue

[Thyroid17 in reply to Thyroid17]

Thyroid meds of course

[Judithdalston in reply to Thyroid17]

yes I hope so …did mine!

[tattybogle]

they make it sound like they've solved a hugely difficult puzzle and want a prize for such a clever observation

when it's more like watching a comedy of errors .

paper should be retitled :

"Failure to include a £5 thyroid function test in 'extensive' workup costs NHS £[the cost of 2 surgeries + all the other guff] "

i've never understood why TFT isn't included in an FBC or some other more routinely done workup ....... why do they think it's unusual and not likely to be worth a look when it must be one of the most common diseases on the planet.

would be interesting to see his full TFT results / timeline since that is what they are supposedly writing about .. it says his fT4 was below range at some point , yet TSH initially only 6 ish ... tpo ab 's jump from 100 to 1000 .. would be interesting to see timescale.

"Emerging evidence suggests a link between musculoskeletal symptoms, including TF, and underlying thyroid disease ... " Emerging ? i seem to remember Theodore Kocher mentioning it at some length in ..... 1909

" the patient was treated with synthetic T4 and levothyroxine for hypothyroidism." Do you think we should tell them that levo IS synthetic T4 ? ..... or shall we just wait another hundred years for them to accidentally figure it out for themselves by removing the surgeons brain.... twice ?

[TSH110 in reply to tattybogle]

lol! Forever reinventing the wheel eh?

He certainly got VIP diagnostic treatment and got Levo with a TSH considered acceptable for us to just watch and wait …and suffer…. , no waiting for over 10 there and three blood tests to see it stays above 10. No one ever tested mine for bugs as a cause either.

Helps to be a male surgeon I guess.

[Judithdalston]

Just before I put myself on DIY T3 I would wake up with my ring fingers bent over unable to self straighten so had to pull them up, and an increasing knot of tendons in the palm of my hand. Now on T3 for over 6 years don’t notice this, and very thick prominent tendon from thumb to index finger on both hands is largely gone…not sure whether this is totally due to T3 or the fact I have been swim 5x a week over the last 20 months and exercise has improved it. But no injections/ surgery needed thank heavens!

[TSH110 in reply to Judithdalston]

I wish NDT would shift mine!

[Judithdalston in reply to TSH110]

Have you enough T3 in the NDT ‘mix’ for you, not that I can tell you what might help it? I was thinking I was getting Dupuytrens Contracture, which my Dad had, so was rather surprised it seemed to get better either from a bit of T3 ( mind you my Ft3 was never out of 3-13% range), and later swimming.

[TSH110 in reply to Judithdalston]

Mine had gone right over the top last time so I’ve cut back but don’t see any change in the “claw”

I think swimming would really help it sorted out my frozen shoulder some years back. Hard to swim with a needy little non swimming hound tho, I haven’t found a way around it yet.

[Judithdalston in reply to TSH110]

I had come across similar finds re low thyroid hormone and collagen/ tendon production / maintenance in other parts of the body in other papers, and have wondered whether different parts of the body show this shortage varyingly ie for some people it’s the fingers, others the neck etc etc., and for me tends to be at different times. I think my fibromyalgia diagnosis relates to this , though my hands have improved, other areas painful and I am thinking of increasing my T3 for a time. Unfortunately I can’t advise on your ‘claw’, although judging from all the other causes the patient in paper was tested for, there must be lots of other causes…according to writers thyroid problems only accounted for 20 something patients out of 100,000 of people with hand tendon problems…does make one say on this forum, ‘Really?’

[TSH110 in reply to Judithdalston]

Tendenopathies are more common in those with thyroid problems according to research but I’d expect it’s much higher than reported, as the medical profession seem unaware of the connection or even openly refute it 😱 when I told a specialist I thought my bakers cyst was related, he laughed at me yet they are more common in those with thyroid disorder - all a totally weird coincidence? I don’t think so - they should be noticing and trying to work out why and how to improve matters!

[SarahJane1471]

I’ve had Carpal Tunnel Syndrome for 6/7 years which I had steroid injections for every 8 months which eased the symptoms. Each time the symptoms began to come back I would get trigger finger in little/ring/middle finger. Since optimising my Levo I have not needed injections for 2 yrs and no more trigger finger 🤷‍♀️. I do still wear wrist splints at night.

[TSH110]

yes got that in middle ring finger had the jab which was hand heaven it felt fantastic but the triggering came back not as badly. There’s a lot of Duputchrens too in my family. Some researchers are of the opinion trigger finger is actually Duputchrens just a lesser presentation. Seems they are good bedfellows too. I also have ledderhose and dreadful Achilles tendinitis which was the first tendinopathy to present. I’m quite sure they are all because of abnormal thyroid function over the decades of non treatment and even with treatment.

3 close family members Duputchrens and various thyroid disorders one also has ledderhose, one cousin Duputchrens thyroid status unknown, me thyroid disorder, trigger finger (I also suspect duputchrens) and ledderhose, another close relative with trigger finger and I’d say undiagnosed thyroid disorder the only one who’s escaped died young

Why is no one studying us? Surely they could glean a mountain of valuable info to explain it all. No we want healthy young men with no illness. Small wonder we’re in the thyroid dark ages

[TiggerMe Ambassador in reply to TSH110]

My head auto corrected that to lederhosen.... made me chuckle 😆

[TSH110 in reply to TiggerMe]

It’s a funny name for lumps under the feet, I think the person first describing it was called Dr Ledderhose. I don’t think we have an equivalent Dr Pants (but strangely there are plenty of those tho!)

[Judithdalston in reply to TiggerMe]

So had mine, and thought perhaps it was a tendon problem in knees…good job iPad to hand to look it up!

[Judithdalston in reply to TSH110]

I had just replied above about thinking my stuck index fingers were going to be Dupuytrens as my Dad had it, but some T3 worked wonders!

[TSH110 in reply to Judithdalston]

That’s great it s a horrid thing. One relative had both hands operated on looked like she’d been crucified it keeps coming back too so she’s had them operated upon twice now, three others have had to resort to the knife too. One asked them to cut off her pinky cos she couldn’t get coats etc on but they didn’t, they just made it go flat again

[SarahJane1471]

my Achilles Tendonititis also disappeared when Levo increased 🤷‍♀️😀