Finger pain

[authorlmtaylor]

Hi, I have a question. For months and months I've been having minor pain in the smallest joint on my fourth finger on my right hand. Because I work seven days a week during the school year, I never saw the doctor. But it started getting worse. It hurts, if my fist is closed, to bump the knuckle from above. It also hurts to stretch my fingers out (laying flat is okay, but if I try to stretch them at all, it hurts). It also hurts to press downward while the finger is flat (scrubbing a counter-top or picking up a heavy book both hurt significantly). Now, two more fingers on my left hand have begun to progress exactly the same way with exactly the same pain.

I got xrays this week of the right hand only, and the xray report says "small ossification or old trauma or calcification proximal interphalangeal joint is seen of the fourth digit. So, looks like some old trauma to the middle joint of the 4th finger. Please keep appt with OT."

Now, there are three things about this I don't understand:

One, why is it that my small joint, and only the small joint, hurts when the "old trauma" is in the middle joint?

If the pain in the finger on my right hand is being caused by an old trauma, why am I getting the exact same pain progression in two fingers on my left hand?

And if it is not an old trauma, but a build up of calcium or bone material, doesn't the fact that it's happening to multiple joints at the same time indicate a bigger problem?

My doctor is very non-communicative and wouldn't discuss this on the phone with me, she just told me I'd get the results in the mail, and she had me make an appointment with an occupational therapist. The xray results don't seem to really fit what is happening, but I'm not a doctor, so I hoped I could get your opinion.

Thanks so much for any information you can give me.

[S. Kaul, MD]

Hi there!

Well, without knowing the relevant clinical details or a detailed clinical evaluation it would be difficult to comment specifically on the situation. The calcification related to an old trauma is unlikely to be responsible for the symptoms. With fractures ruled out on the x-ray, other possibilities that may need to be considered include injuries to tendons/ ligaments, infection, inflammation, degeneration, neuro-muscular causes etc. I would suggest getting this evaluated by an orthopedician or a sports medicine specialist for an accurate diagnosis and appropriate management. Meanwhile I would suggest resting the hand. tylenol/ OTC NSAIDS may be helpful for pain relief.
Hope this is helpful.

Take care!

[authorlmtaylor]

Just to update this, I went to the OT people today, and they agreed with me that the xray results above have nothing to do with the finger problem I'm describing.

Unfortunately, they have no idea what COULD be causing the finger pain. I have to see musculoskeletal doctor on june 5th. Just hoping it's not RA :S