Chances of having RA?

[Mountainoutofmole]

Hi Dr-

I am 27 y.o. M with no significant PMH.

I have been experiencing some mild pain in my L 5th DIP joint. It has been going on since last night. There is no pain in any other joint and I don't have any morning stiffness or history of prior joint pain. In addition, there is no swelling of my joint (e.g. no synovitis or tenosynovitis). It doesn't feel warm, and it looks completely normal. I even measured it and compared it to my R handed joint and they were approx the same size. There was no trauma that I remember. I have been taking naprosyn with minimal relief. Pain is about 2/10 and goes to about a 3/10 when I move it. Honestly, it is totally tolerable, but I am more worried if this is the start of something bigger to come, especially since I didn't injure the joint in any way (that I can remember).

I've recently had a physical with completely normal CBC, Chem panels, and LFTs.

I'm supposed to be leaving on a trip today to Europe, but don't know if I should go. If this is the start of RA, I don't want to be overseas when things flare up as I know it can be very debilitating.

How long should I wait for this pain to go away before I go see my PMD? Should I get tested for the RF and anti-CCP in the meantime?

[Kevin Pho, MD]

There is no single laboratory test or study that can confirm the diagnosis of RA.  The following studies should be considered in conjunction with the clinical picture.

Tests for viral infection (eg, hepatitis B virus, hepatitis C virus, parvovirus B19), as well as anti-CCP, RF, and ANA should all be done and discussed with your rheumatologist.

I would also consider imaging the affected joints with plain films.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[Mountainoutofmole]

I also forgot to mention that there is minimal pain/discomfort in my L 5th PIP as well, and I don't have any history of skin rashes or psoriasis.