Red Dots and Purple Swelling on Finger Joints: What Could It Be?

There are red spots on the finger joints with purple protrusions?

Hello, doctor.
About two years ago, I experienced pain in the joint of my left thumb when pressing on it, so I consulted an orthopedic specialist.
After an X-ray, the doctor indicated that there was no issue and prescribed me a bruise ointment.
Shortly after, the pain subsided.
This past year, a red spot suddenly appeared in that area, which was painless and resembled blood pooling under the skin.
I didn't pay much attention to it.
Recently, a second red spot emerged, and the surrounding area became more purple, resembling a bruise, and it feels swollen and painful when pressed.
The blood spot disappears when I lightly scrape it with my finger, but it reappears immediately after I release it.
I'm wondering if this could be due to microvascular rupture or a joint injury, although there was no external trauma.
Should I consult a dermatologist, an orthopedic specialist, or a rheumatologist?

Betty, 20~29 year old female. Ask Date: 2023/05/18

Dr. Li Shengkai reply Cardiology

Based on your description, it is important to consider whether it is vasculitis.
It is recommended to consult a rheumatologist for further evaluation.

Reply Date: 2023/05/18

More Info

Based on your description of the symptoms involving red dots and purple swelling on your finger joints, it is essential to consider a few potential causes. The fact that you previously experienced pain in the same area, which was resolved with treatment, suggests that there may be an underlying issue that has not been fully addressed.

The appearance of red dots that resemble blood pooling under the skin, along with the purple swelling, could indeed indicate a few possibilities. One common cause for such symptoms is the rupture of small blood vessels, known as petechiae or purpura, which can occur due to various reasons including trauma, inflammation, or even certain medical conditions. The fact that the red dots disappear when you press on them and reappear afterward suggests that they may be related to microvascular changes, possibly due to increased pressure or inflammation in the area.

Another possibility is that the swelling and discoloration could be related to a joint issue, such as synovitis, which is inflammation of the synovial membrane that lines the joints. This can occur without significant trauma and may be associated with conditions like rheumatoid arthritis or other inflammatory arthropathies. Given that you have a history of joint pain in the same area, it would be prudent to consider this as a potential cause.

In terms of where to seek medical advice, it would be beneficial to start with a visit to a rheumatologist or an orthopedic specialist. A rheumatologist can evaluate for autoimmune or inflammatory conditions that could be causing your symptoms, while an orthopedic doctor can assess for any structural issues within the joint itself. If there are concerns regarding the skin manifestations, a dermatologist may also be involved in the evaluation, especially if there are any signs of skin-related conditions.

In addition to seeking medical advice, it is important to monitor your symptoms closely. If you notice any changes such as increased pain, swelling, or the development of new symptoms (like fever or systemic symptoms), you should seek medical attention promptly.
In summary, while the symptoms you describe may not indicate a severe injury, they warrant further investigation to rule out any underlying conditions that could be contributing to your symptoms. Early diagnosis and treatment can help prevent potential complications and improve your overall joint health.

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