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Family Physician

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What causes swollen painful joints in right fingers?

Answered by
Dr. Shoaib Khan

General & Family Physician

Practicing since :2009

Answered : 9409 Questions

Posted on Sat, 9 Aug 2014 in Bones, Muscles and Joints
Question: I have been getting a lot of joint pain in my right fingers with swelling, left shoulder and toes. It started about 6 months ago. I am male, 57. I had some blood work done and my RA factor was very high, also showed low vitamin D and B6. I have been taking vitamin supplements but it doesn't seem to help. Worst in the morning, especially feet.
Answered by Dr. Shoaib Khan 1 hour later
Brief Answer:
Need a few investigations sir,suspecting arthritis

Detailed Answer:
Hello sir and welcome.

Thank you for writing to us sir

I have gone through your query with diligence and would like you to know that I am here to help you sir.

Of course, high RA factor is suggestive of rheumatoid arthritis which could be why you are experiencing all the symptoms, but the RA factor is elevated in many other conditions as well. Which is why I would like to recommend getting the following investigations done sir:
-CCP (cyclic citrullinated peptide): This is more accurate in diagnosing rheumatoid arthritis sir
-X-ray of the affected joints which will show signs of damage
-Serum uric acid: I would like to rule out high uric acid also sir, although the location of swelling is not typical for high uric acid, I would still recommend this test sir

I would also like to know the following sir:
-Any history of injuries to the affected region
-Involvement in sports or other activities that involve repetitive involvement of the affected joints
-Family history of arthritis
-Your current weight and height sir

I hope you understand why further investigations are required. Of course, addressing the vitamin deficiencies is also important, but I do not think your symptoms and the deficiencies are related. Which is why I would suggest continuation of the nutritional supplements, but more importantly the investigations.

I hope you find my response both helpful and informative. Please feel free to write back to me for any further clarifications and/or with the test results. I am always available to help.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Shoaib Khan 2 hours later
B6 3.2 low, RA factor 315.7 high , vit d,25 hydroxy low, CRP PROTIEN 13.07 high, SEDIMENTATION RATE WESTERGREN 10. ANA LUPUS NEGATIVE, MOST PAIN IN MORNING WHEN GETTING UP IN FEET AND LEFT SHOULDER, RIGHT HAND POINTER AND MIDDLE FINGER SWOLLEN AND NOT ABLE TO FULLY BEND, WORK AS A MECHANIC FOR 40 years. Most pain in feet on ball of feet at toe joints more so in left foot.height 5'8", weight 210
Answered by Dr. Shoaib Khan 6 minutes later
Brief Answer:
Need more tests to confirm cause sir

Detailed Answer:
Hello once again sir.

Thank you so much for that information sir, it really helped. But I still think it would greatly help to get the investigations mentioned in my previous response, to establish an accurate diagnosis sir.

The provided results do indicate the presence of a condition like arthritis, but this will have to be confirmed. Please consult your doctor with the test results or write back to me and I shall surely interpret them for you to help you with the way forward sir.

I hope you find my response helpful sir. Please feel free to write back to me any time, I am always available to help.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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