My mom has persistent muscular and joint pain with swelling and finger nodules. Is this rheumatoid arthritis?

Question

Hello doctor,

I am asking a question on behalf of my mother who is currently under investigation for rheumatoid arthritis. Her main symptoms are joint and muscular pain that is consistent throughout the day, swollen joints, and some visible nodules on her fingers. Some blood work has been performed and here are some primary results that you may be interested in. Anti-cyclic citrullinated peptides (anti-CCP) antibodies negative (last tested five years ago). C-reactive protein (CRP). She is currently on Lipito 20 mg and Concor 2.5 ml.

Answer 1

Hi,

Welcome to icliniq.com.

It seems she has more of osteoarthritis than rheumatoid arthritis. The nodules you have marked in the photograph (attachment removed to protect patient identity) are Heberden's nodes and are classical of osteoarthritis.The involvement of the distal interpharyngeal joint of the hand virtually rules out rheumatoid arthritis. Just mere positivity of rheumatoid factor does not make a diagnosis. That too when CRP and anti-CCP antibody negative. So, in my opinion, it would be to better to prescribe her Tramadol for pain relief along with lots of Calcium and vitamin D. A cortisone shot may help her if the pain is severe.

I hope this helps.