[49F] Experiencing joint pain, swelling, and Raynaud's phenomenon

Patient Description

A 49-year-old female presents with a 3-year history of constant, severe joint pain rated 8/10, described as both sharp and aching, affecting hands, feet, hips, and elbows. The pain is accompanied by morning stiffness lasting more than an hour, and puffy, tender, red swelling in both hands, exacerbated by overuse and fine motor activities. Notably, subchondral cysts are present on the metacarpal joints. The patient has been diagnosed with Raynaud's phenomenon since her late twenties. She is currently taking methylphenidate 36mg four times a week and daily supplements of Omega 3 and biotin, with no known drug allergies or family history of autoimmune diseases.

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Arora's Assessment

What might be happening

Based on the information provided, the following conditions could be causing your symptoms:

  • Rheumatoid Arthritis (RA): This is an autoimmune disease that causes chronic inflammation of the joints. It typically affects the small joints in the hands and feet, causing pain, swelling, and stiffness. The stiffness is often worse in the morning and after periods of inactivity. Over time, RA can cause joint deformities and mobility issues.

    • Treatment for RA usually involves medications to reduce inflammation and slow the progression of the disease, physical therapy, and sometimes surgery.
  • Psoriatic Arthritis: This is a type of arthritis that affects some people who have psoriasis, a condition that features red patches of skin topped with silvery scales. Most people develop psoriasis first and are later diagnosed with psoriatic arthritis, but the joint problems can sometimes begin before skin patches appear.

    • Treatment typically involves medications to reduce inflammation and slow the progression of the disease, physical therapy, and sometimes surgery.
  • Lupus: This is an autoimmune disease that can cause inflammation and pain in any part of your body. It's difficult to diagnose because its signs and symptoms often mimic those of other ailments.

    • Treatment typically involves medications to reduce inflammation and manage symptoms, as well as lifestyle modifications.

Please note that these are potential explanations for your symptoms, but only a healthcare professional can provide a definitive diagnosis.

What you can do

  1. Make an appointment with your primary care doctor. If they suspect you have an autoimmune disease, they may refer you to a rheumatologist, a doctor who specializes in these types of conditions.
  2. Keep a symptom diary. This can help your doctor understand what's going on and make a diagnosis. Note when your symptoms occur, how long they last, and what makes them better or worse.
  3. Stay active. Regular physical activity can help keep your joints flexible. However, avoid activities that cause pain or swelling in your joints.
  4. Apply heat or cold to your joints. Heat can help ease your pain and relax tense, painful muscles. Cold may dull the sensation of pain and reduce muscle spasms.

What you should look out for

Contact your doctor if:

  • Your joint pain, swelling, or stiffness gets worse.
  • You develop new symptoms.
  • You have a fever, which could indicate an infection or a flare-up of an autoimmune disease.
  • You're not getting relief from your current treatment.

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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9 mo ago


People Also Ask


What are the common symptoms of rheumatoid arthritis?

Common symptoms of rheumatoid arthritis include joint pain, swelling, and stiffness, particularly in the morning or after periods of inactivity. It often affects the small joints in the hands and feet and can lead to joint deformities over time.


How is Raynaud's phenomenon related to autoimmune diseases?

Raynaud's phenomenon is a condition where small blood vessels in extremities like fingers and toes constrict excessively in response to cold or stress, leading to color changes, numbness, and pain. It can be associated with autoimmune diseases, as these conditions can affect blood vessels and circulation.


What lifestyle changes can help manage joint pain associated with autoimmune conditions?

Lifestyle changes that can help manage joint pain include regular physical activity to maintain joint flexibility, applying heat or cold to affected areas to reduce pain and swelling, maintaining a healthy weight, and avoiding activities that exacerbate joint pain.


What are subchondral cysts and how do they affect joint health?

Subchondral cysts are fluid-filled sacs that form in the bone beneath the cartilage of a joint. They are often associated with arthritis and can contribute to joint pain and stiffness by affecting the integrity and function of the joint.

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