Dr. Sadaf Mustafa
Internal Medicine
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am having trigger problem in the middle finger of my left hand for over a year. But, the same fingers of my right hand have now developed the same problem. They are especially bad in the morning and it is difficult to straighten them. I can feel a very heavy click when I do it. I had blood tests to test for arthritis and they came back clear. I was diagnosed with breast cancer last year and treated with chemotherapy, mastectomy and radiotherapy. I have mentioned the problem with my fingers to each of these specialists and none of them had an answer. Everyone said that it is not a side effect of any of the treatments. Currently, I am taking Aromasin inhibitors and Triptorelin. I am very much worried and confused at the moment. I cannot seem to find any answer as to know what it is. Please help.
Hi,
Welcome to icliniq.com. The most important information to know would be an x-ray of your hands. There are different types of arthritis like autoimmune, osteoarthritis, and gout. It could also become worse with your new medications as they can cause bone loss and pain. It may also occur if you have an atypical fracture. Also, autoimmune testing could be done by just the ANA test (antinuclear antibody) or could be more like a rheumatoid factor. Rheumatoid arthritis (could be RF positive or negative), psoriatic arthritis (may occur before the rash), gout, pseudogout (form of arthritis, swelling of joints last for some days or weeks), osteopenia or osteoporosis could be causing atypical fractures. Less likely, it could be metastatic disease. I would suggest you take an X-ray of your hands, test for vitamin D levels, ANA (anti-nuclear antibody test), Anti-CCP (anti-cyclic citrullinated peptide antibody), rheumatoid factor, and CBC (complete blood count). Treatment plan will depend upon the results. I would suggest using 2000 IU of Vitamin D and Calcium 800-1200 mg per day. Take Ibuprofen 400-600 mg twice daily for pain with food. If possible get a splint to minimize active movement.
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Internal Medicine
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