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Have swelling, soreness and tenderness of MCP of index joint and tenderness of PIP. Bilateral iliotibial band syndrome?

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Rheumatologist
Practicing since : 2008
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Recently submitted case involving moderate swelling, soreness and some tenderness of MCP of index joint on right hand and slight tenderness of PIP on ring finger of same hand post workout with heavy dumbells. If possible, please review prior case.

Now, post a leg workout involving squats with heavy weight without stretching or warming up 4 days ago have developed some tenderness along outside of both knees. I have no stiffness, swelling, fever, etc. that would be indicative of Rheumatoid other than the tenderness upon palpation.

The tenderness is just above the joint line on the femur side of the joint. It is almost absent when flexed at a 90 degree angle but very present upon palpation if the joint is extended. I'm wondering if this is just a coincidental case of bilateral Iliotibial band syndrome from the workout or symptomatic of RA.

I will also note that swelling and tenderness of MCP has subsided and PIP is greatly reduced. Both onset two weeks ago today.

I have an appointment to get standard RA blood work done but would appreciate your view prior to receiving results if possible.
Posted Wed, 31 Jul 2013 in Lupus
 
 
Answered by Dr. Shruti Rijhwani 15 hours later
Hi !

Thank you for your query.

Dear sir,

Well reviewing your complaints it is very difficult to exactly give you a diagnosis but I can discuss the issue .

Complaints with your knee that is the pain you are mentioning may not be a part of rheumatoid because knee joint is generally not involved in rheumatoid arthritis .

But swelling on your MCP joint is quite indicative of this disease . Since you tell that the swelling and tenderness have subsided it can be indicative of Palindromic rheumatism in which you can see such kind of presentation . It is an inflammatory arthritis that causes sudden inflammation in one or many joints, lasts a few hours to a few days, and then the inflammation subsides completely to return back again .

There are symptom free periods between attacks lasting for weeks to months . I advise you to see a rheumatologist and get RF , Anti - CCP , ESR , CRP etc. done to see for any evidence of inflammatory arthritis . Clinical judgement plays an important role in diagnosis of these diseases and thus evaluation is necessary.


Hope you are satisfied with the answer.

Wish you good health.

Take care.

Dr. Shruti
Above answer was peer-reviewed by
 
Follow-up: Have swelling, soreness and tenderness of MCP of index joint and tenderness of PIP. Bilateral iliotibial band syndrome? 34 minutes later
Thanks for your response. Were you able to review the prior case I submitted? I ask because there I noted that the swelling was actually between 2 MCP joints not swelling of the joint itself. I am getting blood drawn today and will post the results here for your interpretation when available.

Cheers
 
 
Answered by Dr. Shruti Rijhwani 6 minutes later
Dear sir,

Thanks for getting back.

No, I was not able to review your care that you have posted prior to this . Kindly get back to me whenever reports are available.

Take care.

Dr. Shruti
Above answer was peer-reviewed by
 
Follow-up: Have swelling, soreness and tenderness of MCP of index joint and tenderness of PIP. Bilateral iliotibial band syndrome? 2 days later
Hi -

Have received 3 of 4 results back from the lab:

RF - 8.7 with reference of 0-13.9
ESR - 2 with reference of 0-15
CRP - .3 with reference of 0-4.9

Is this positive? What is the likelyhhod of this being rheumatoid with these results? Will post anti-ccp when available.
just got anti-ccp... result was 2 with reference of 0-19
 
 
Answered by Dr. Shruti Rijhwani 55 minutes later
Dear sir,

Thanks for getting back.

Well all your reports are within normal range but sometimes arthritis does persist with inflammatory markers being normal . At present I will advise you to wait and watch . whenever you get swelling of any joint get your tests done at that time may be then we can have some evidence . Presently there is nothing to worry.

Take care.

Dr. Shruti
Above answer was peer-reviewed by
 
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