Does finger deformity must be caused by rheumatoid arthritis?
Aunt Li, 60, is the main force of housework at home, washing, cooking, and cleaning.
However, in recent years, as she gets older, Aunt Li has gradually discovered that she is no longer as energetic as she was when she was young, and she often has pain in the joints of her hands when she works more.
When I woke up in the morning, my hands were stiff and it was difficult to make a fist. I needed a few exercises to recover.
Because I was too busy at ordinary times, I never went to the hospital for treatment.
Slowly, Aunt Li found that her fingers had begun to deform and were no longer straight.
Relatives and friends all persuaded Aunt Li: "Your fingers are like this. You must have rheumatoid arthritis. You can take a look."
Aunt Li was also very nervous when she heard this. When she searched the Internet, it was said that she must be rheumatoid arthritis and will be disabled in the future.
This frightened her, and she finally made up her mind to go to a regular hospital for an examination.
Rheumatoid arthritis or osteoarthritis?
The doctor performed a detailed physical examination for Aunt Li and asked Aunt Li if she had any symptoms of knee pain when she went up and down the stairs.
Aunt Li said that this symptom has been around for some years, and it has even worsened in recent years.
After listening to Aunt Li’s description, the doctor told Aunt Li: “You’re a typical osteoarthritis, not rheumatoid arthritis.”
Aunt Li was stunned: "Osteoarthritis? Isn't it rheumatoid? Doctor, people say that if the joint is deformed, it is rheumatoid."
Faced with Aunt Li’s doubts, the doctor explained to Aunt Li that the most common swelling and painful joints in rheumatoid arthritis are the proximal interphalangeal joints, metacarpophalangeal joints and wrist joints.
The involvement of the distal interphalangeal joints is relatively rare, and even the involvement is generally accompanied by the involvement of the joints in the other joint areas mentioned above.
However, the most common manifestation of osteoarthritis in the hand is the involvement of the distal interphalangeal joints, and the bony bulge of the distal interphalangeal joints, called Heberden nodules, is a prominent sign of osteoarthritis.
As the disease progresses, there can be deformation and deflection of the distal interphalangeal joints, which are called serpentine fingers.
Now Aunt Li understood that her hand symptoms were typical osteoarthritis.
At the same time, osteoarthritis is prone to the symptoms of large joints of the lower limbs, especially the knee joints. The initial manifestation is knee joint pain during weight-bearing activities, especially the most common symptoms of up and down stairs.
Regarding Aunt Li's situation, the doctor said that it is right to actively go to the hospital for treatment.
Osteoarthritis has a high incidence among the elderly, and it is difficult to distinguish it by the patient's own judgment.
And some patients with osteoarthritis will have rheumatoid arthritis, and some patients with erosive osteoarthritis will be more difficult to distinguish from rheumatoid arthritis.
Therefore, it is very necessary to have suspicious symptoms in the rheumatology department of a regular hospital, and it is very necessary to be evaluated and diagnosed by a specialist. There is no need to be over-stressed because some fragmented information is searched on the Internet.
Text/Zhang Jingfeng (Peking University Third Hospital)