What causes DIP joint pain in both hands?

Question

Hi doctor,

I am a 25-year-old male with a family history of rheumatoid arthritis (mother). For the past two to three weeks, I have been experiencing pain in the DIP joints of both hands, mainly triggered by typing and prolonged computer use, with no pain at rest or at night. Morning stiffness initially lasted five minutes and has now decreased to two minutes. There is no visible swelling, redness, or deformity. I have been taking Arcoxia 90 mg daily for over seven days, and while there was no improvement in the first five days, the pain is now nearly not there at rest, though it still returns mildly with extended typing or stress.

All laboratory investigations are negative, including RF, anti-CCP, ANA, ESR, and CRP. Additionally, I have very severe flat feet and a high joint hypermobility score (Beighton 8/10). Foot pain, which was previously significant, has also improved notably with Arcoxia. There is no known history of psoriasis or systemic symptoms. I am seeking input on whether this presentation could reflect early inflammatory arthritis, mechanical joint stress (e.g., RSI or early OA), or hypermobility-related joint pain, and whether imaging or further testing is recommended.

Please help me.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

Thanks for the detailed history. It provides a clear clinical picture. You are a 25-year-old male presenting with pain in the distal interphalangeal (DIP) joints of both hands, primarily triggered by prolonged mechanical use such as typing. There is a brief duration of morning stiffness, initially around five minutes, and now reduced to approximately two minutes. There are no signs of joint swelling, redness, or warmth.

Autoimmune and inflammatory markers, including rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), antinuclear antibody (ANA), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Notably, you exhibit marked hypermobility (Beighton score 8/10) and have severe flat feet. While there has been a significant response to nonsteroidal anti-inflammatory drugs (Arcoxia), the pain appears to be predominantly mechanical in nature. There is no personal or family history of psoriasis or systemic features. Overall, this presentation is most consistent with mechanical or overuse joint pain, with a likely contribution from hypermobility syndrome.

Thank you.