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Sore Finger Joints
July 2000

Q. I am a 25-year-old female, who works on a computer all day. For the last three months I have been experiencing pain in the joints of my right hand, especially in that of the fifth digit. On many occasions it has gotten to the point where I couldn't bend the finger because the pain was too severe. I went to my doctor who ran blood tests, which did not uncover a problem. The strange thing is that I do not always experience this problem, it seems to be random. Also, I am now having problems with the third finger joint. It appears to be swollen and is very tender to the touch. My doctor said that she was puzzled as to the cause and said not to worry about it too much. However the pain is increasing. Since the blood test did not turn up anything, should I see another doctor? Or should I see a hand surgeon? I'm a little lost right now and in a lot of pain.

A. Your joint pains can be any one of a host of conditions, some of which are self-limited and some are more serious. The fact that your blood tests are normal eliminates most of the serious problems (assuming that your doctor checked the blood tests that I think she checked). The one thing that you haven't mentioned is which of the joints in your affected fingers are involved. For example, is it the joint where the finger joins the palm, or one of the more distal joints in that finger? It turns out that which joints are affected helps us determine what the underlying disease process might be.

Seeing a hand surgeon is most likely not appropriate at this time. (To clarify: if your doctor after evaluating you feels that this is a surgical problem, I would concur. However, just based on the history that I see here it is unlikely that a surgeon would be the appropriate referral). If you are not happy with the answers your physician is giving you, you have two options. First, try an anti-inflammatory medicine for a few weeks to see if this helps. Second, be referred to a rheumatologist for another opinion. You can learn more about rheumatologic diseases at http://www.rheumatology.org/patients/factsheets.html. The problems that are most likely to affect a young woman like yourself include systemic lupus erythematosus and rheumatoid arthritis. You can check those diseases on the Web site. Again, you most likely do not have these problems as tests for these conditions are probably what your physician checked.

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