Were your symptoms similar to mine? Seems no one can give me a clear answer.
Hi,
I’m a 36 year old female, and I’ve been experiencing intermittent swelling of my fingers, originally only in one hand, but more recently in both. It affects some fingers more than others, but occasionally the whole hand is affected. I had an RA factor test and it was negative. My knuckles are red and some show signs of what looks almost like a blister or rash. My hands itch and are painful from the swelling. I don’t feel like my doctor is taking my concerns seriously, despite providing photos of the swelling. I’m uncomfortable and worried that I need to address this. I have no family history on my mom’s side of PsA but don’t have any knowledge of my father’s. Any help or advice is appreciated. 
Hello
, thank you for reaching out. I can hear what a difficult and frustrating situation you are in currently, feeling that your doctor is not adequately addressing your concerns. While we are not doctors, and can not make diagnoses, I do want to share some information with you about PsA symptoms as well as diagnosis. Some people do find that finger swelling and pain to be one of the first symptoms. I'm sharing a link to an article with more information on early signs and symptoms, https://psoriatic-arthritis.com/psa-symptoms. And this article is specific to fingers (and toes), https://psoriatic-arthritis.com/psa-symptoms/joints-fingers-toes.
Was it your general practitioner who you have seen about these symptoms so far? The one who ran the RA factor test? You might ask if you could get a referral to a rheumatologist as they specialize in these types of conditions. I'm also including a link to an article about diagnosis, https://psoriatic-arthritis.com/medical-history-exam-diagnose. Unfortunately, it sometimes can be challenging to get a diagnosis of PsA, but whatever is causing your symptoms, your doctor should be supporting you and helping investigate what is causing them. Please don't hesitate to advocate for yourself and push for answers if you need to.
I hope that this information can help give you a starting point, and that some of our community members here can connect with you about their experiences as well.
Please don't hesitate to reach out here anytime, whether you have more questions, need to vent, or could use some support. Sending you gentle hugs. -- Warmly, Christine (Team Member)Hi! A quick update. My primary care doctor ordered an ANA test, which came back negative. She hasn’t provide a referral to see a rheumatologist, and I don’t think she believes it’s necessary. From your experience, is that typically the case? Most specialists where I live will not see patients without a referral, regardless of the type of insurance coverage. I am not sure if I should keep pushing back, as I’m not too familiar with what the tests do and do not rule out. As always, any guidance is appreciated!
Hi,
Thank you so much for this response and for the resources! Yes, it’s my primary care doctor that’s been discussing my symptoms and ordering tests, but once the RA test came back with a number in the normal range, she hasn’t pursued it further.
I’ll do some additional research and probably schedule an appointment with a rheumatologist.
I appreciate your help!
Sara, please, if you're comfortable, keep us posted! I hope that you can connect with a rheumatologist and get some answers. Also, I wanted to share another article with you, this one "what to expect at the rheumatologist office", https://psoriatic-arthritis.com/living/what-to-expect-rheumatologists-office, written by one of our health leaders. I do hope you can get some support and answers! -- Warmly, Christine (Team Member)
Thank you, again! These are very helpful. I appreciate it!
Not a doctor, but photos of your hands look identical to mine. The proximal interphalangeal (PIP) joints on your hands show the same swelling, and a couple of your distal interphalangeal (DIP) joints, your middle fingers specifically, share the same characteristic appearance that results from “pencil in cup”, a deformity that is common in PsA. Many doctors do not understand that PsA can exist without the lesions and scales typical of psoriasis, which is why we all need to advocate for a name change for this disease. My own experience started solely with joint involvement, and I only ever developed psoriasis on my knees and elbows in the year or two following a motorcycle wreck that resulted in road rash on those areas, and it never developed anywhere else. PsA is usually asymmetrical in nature, and you say that you tested negative for RA factor, so a referral to a rheumatologist is certainly in order. You are going to have to advocate for yourself. This is not a disease that is all that well understood, even by experts. And there are medications that, if prescribed in the early stages of PsA, can go a long ways toward slowing down its progression significantly.
Thank you so much for this insight! I went through all the common suggestions from doctors and the internet (frighteningly). There was no common driving factor that coincided with the swelling. It’s not chillblains or trigger finger or an allergy. One random morning I woke up and my rings barely fit over my knuckles. I can no longer wear them, as my knuckle joints have never fully returned to their original size. I’ve noticed what looks to be a deformation of my ring and pinky finger on my right hand, with much less impact overall on the left. There are periods where the swelling is almost nonexistent, and then it will get very bad for a week or two. Occasionally I do get small reddish bumps over my affected fingers, but weirdly they never progress into anything else and never seem to go completely away. I’ve never had psoriasis or any other skin condition, and this was honestly the first I’d heard of psoriatic arthritis. I struggle to do some of the finer tasks I used to; crocheting is challenging depending on the day, but most other things are doable, though occasionally uncomfortable. If that’s what this is, I would very much like to get a handle on it early to potentially slow down any damage. I am starting to see that it’s likely going to be up to me to nail this down, as I don’t think my PCP is going to push the issue.
