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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does Soreness On The Knuckles Indicate?

Hello, My pointer finger on my right hand is sore at the knuckle. I play guitar as my profession. This is my plucking/strumming hand. I started to notice about a month ago that my knuckle was tender. If I touch it, it is tender. If I bump it on something, it hurts. Was wondering if you might have an idea what of what is going on. Thank you!
Thu, 16 Aug 2018
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General & Family Physician 's  Response
Hello and Welcome to ‘Ask A Doctor’ service.


I have reviewed your query and here is my advice.





Soreness may be due to overuse, since you are a professional guitarist. But one main thing which has to be ruled out in your case is rheumatoid arthritis. you need to consult an orthopedic surgeon or rheumatologist for that. Sometimes it can be difficult to tell whether your symptoms are those of RA or the more common wear and tear arthritis called osteoarthritis (OA).





Either diagnosis should be confirmed by someone who is an expert in arthritic diseases, usually a rheumatologist.





1. Usually with RA, one or more of your finger knuckle joints will be swollen. The swelling or inflammation is more likely to be in the middle or large knuckles of your hands not the knuckles at the tips of your fingers next to your fingernails. It is often in the same joints on both hands (the swelling is symmetrical). The swelling does not feel "bony," but rather tender and slightly soft. With RA, you may also feel warmth and notice redness over the inflamed joint.





2. At least one of your middle or large knuckles has been swollen and painful for more than six weeks. If there's no clear reason or explanation for this, it could be a sign of RA. Large joints, such as your ankles, knees, shoulders, or elbows, may be involved, but you must have swelling and pain in at least two joints to be diagnosed with rheumatoid arthritis. On the other hand, swelling or pain in your small fingertip knuckles, at the base of your thumbs, and in your big toe joints will more often be due to OA.





3. The balls of your feet are also targets for RA. Often, people with rheumatoid arthritis experience a feeling of "walking on golf balls" or swelling under the foot, especially first thing in the morning when getting out of bed. This pain will feel different from pain caused by a bunion. Pain from a bunion is usually at the base of the big toe, and feels worse when you wear tight shoes.





4. You just don't feel well, and you may notice bumps on your elbows. With RA, you may have flu-like symptoms, such as low-grade fevers, stiffness, and fatigue from inflammation. Occasionally, small tender bumps or nodules under the skin will develop with RA, often near the back of the elbow. These are called rheumatoid nodules.


5. Your joints are particularly stiff for more than an hour in the morning. With rheumatoid arthritis, you may find it difficult to completely make a fist. You may have unusually tender swelling on the top of your wrists along with stiffness. If your elbows are involved, it may be difficult for you to straighten them completely. Usually, you won't have swelling or pain in your hip joints early in the course of RA. Painful hip joints more often are due to OA, and most people feel the pain in the front of the hip or in the groin region.


6. Certain blood tests may help determine whether you have RA. These are usually ordered by your health provider, but there are companies that allow you to order these tests yourself (Hint: Google search order your own lab tests). Four important tests are usually ordered for an RA diagnosis. Two measure proteins in your blood called antibodies: Rf (rheumatoid factor) and CCP (anti-cyclic citrullinated peptide). The other two measure inflammation: ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein). With RA, at least one Rf or CCP test must be positive and at least one CRP or ESR test must be abnormal.





Hope I have answered your query.


Let me know if I can assist you further.
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What Does Soreness On The Knuckles Indicate?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Soreness may be due to overuse, since you are a professional guitarist. But one main thing which has to be ruled out in your case is rheumatoid arthritis. you need to consult an orthopedic surgeon or rheumatologist for that. Sometimes it can be difficult to tell whether your symptoms are those of RA or the more common wear and tear arthritis called osteoarthritis (OA). Either diagnosis should be confirmed by someone who is an expert in arthritic diseases, usually a rheumatologist. 1. Usually with RA, one or more of your finger knuckle joints will be swollen. The swelling or inflammation is more likely to be in the middle or large knuckles of your hands not the knuckles at the tips of your fingers next to your fingernails. It is often in the same joints on both hands (the swelling is symmetrical). The swelling does not feel bony, but rather tender and slightly soft. With RA, you may also feel warmth and notice redness over the inflamed joint. 2. At least one of your middle or large knuckles has been swollen and painful for more than six weeks. If there s no clear reason or explanation for this, it could be a sign of RA. Large joints, such as your ankles, knees, shoulders, or elbows, may be involved, but you must have swelling and pain in at least two joints to be diagnosed with rheumatoid arthritis. On the other hand, swelling or pain in your small fingertip knuckles, at the base of your thumbs, and in your big toe joints will more often be due to OA. 3. The balls of your feet are also targets for RA. Often, people with rheumatoid arthritis experience a feeling of walking on golf balls or swelling under the foot, especially first thing in the morning when getting out of bed. This pain will feel different from pain caused by a bunion. Pain from a bunion is usually at the base of the big toe, and feels worse when you wear tight shoes. 4. You just don t feel well, and you may notice bumps on your elbows. With RA, you may have flu-like symptoms, such as low-grade fevers, stiffness, and fatigue from inflammation. Occasionally, small tender bumps or nodules under the skin will develop with RA, often near the back of the elbow. These are called rheumatoid nodules. 5. Your joints are particularly stiff for more than an hour in the morning. With rheumatoid arthritis, you may find it difficult to completely make a fist. You may have unusually tender swelling on the top of your wrists along with stiffness. If your elbows are involved, it may be difficult for you to straighten them completely. Usually, you won t have swelling or pain in your hip joints early in the course of RA. Painful hip joints more often are due to OA, and most people feel the pain in the front of the hip or in the groin region. 6. Certain blood tests may help determine whether you have RA. These are usually ordered by your health provider, but there are companies that allow you to order these tests yourself (Hint: Google search order your own lab tests). Four important tests are usually ordered for an RA diagnosis. Two measure proteins in your blood called antibodies: Rf (rheumatoid factor) and CCP (anti-cyclic citrullinated peptide). The other two measure inflammation: ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein). With RA, at least one Rf or CCP test must be positive and at least one CRP or ESR test must be abnormal. Hope I have answered your query. Let me know if I can assist you further.