Is It Time for a Rheumatology Consult for My Mom's Joint Issues?

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My mother is 56 years old.
Over the past year, I have noticed that her fingers have become deformed, varying in size, with bends and curves, and they are painful, especially when she does any activity.
She visited a physician at a major hospital in Tainan, who just laughed and said it was due to age-related degeneration.
My mother swims 1000 meters every day and takes OPC, selenium, blue-green algae, and DHEA daily.
Others say she looks very healthy, youthful, and energetic.
However, today I noticed that her toes are also deformed and there is swelling (or edema) present.
I am puzzled and wonder if I took her to the wrong specialist—should she see a rheumatologist instead of an orthopedic doctor? Please help me.

Tainan Miss Chen, 50~59 year old female. Ask Date: 2001/07/24

Dr. Lin Mingxing reply Family Medicine

It is recommended that you visit a rheumatology and immunology department for further examination or blood tests for differential diagnosis.

Reply Date: 2001/07/24

More Info

It sounds like your mother is experiencing significant joint issues that are concerning, especially given the changes in her fingers and the presence of swelling. Based on the symptoms you've described, it may indeed be time for a rheumatology consult.
Rheumatologists specialize in diagnosing and treating conditions that affect the joints, muscles, and bones, including autoimmune diseases such as rheumatoid arthritis (RA), lupus, and other inflammatory conditions. The deformities in your mother's fingers, along with the pain and swelling, could be indicative of an underlying rheumatological condition rather than just age-related degeneration.
Rheumatoid arthritis, for example, often presents with joint deformities, morning stiffness, and swelling, particularly in the hands and feet. It can affect individuals at various ages, and while it is more common in older adults, it can also occur in younger individuals. The fact that your mother is experiencing pain with minimal activity and has developed deformities suggests that a more thorough evaluation is warranted.

In addition to the physical examination, a rheumatologist may order specific blood tests to check for markers of inflammation and autoimmune activity, such as rheumatoid factor (RF), anti-citrullinated protein antibodies (anti-CCP), and others. These tests can help differentiate between various types of arthritis and guide appropriate treatment options.

Regarding the treatments your mother is currently undergoing, including OPC (Oligomeric Proanthocyanidin Complex), selenium, blue-green algae, and DHEA (Dehydroepiandrosterone), it's essential to discuss these with the rheumatologist. While some supplements may have health benefits, they should not replace conventional treatments, especially if a significant inflammatory condition is present.

In terms of next steps, I recommend scheduling an appointment with a rheumatologist as soon as possible. They can provide a comprehensive assessment and determine if your mother has a condition that requires specific treatment, such as disease-modifying antirheumatic drugs (DMARDs) or biologics, which can help manage symptoms and slow disease progression.

In summary, given your mother's symptoms—joint deformities, pain, and swelling—it is advisable to seek a rheumatology consultation. Early diagnosis and intervention can significantly improve her quality of life and potentially prevent further joint damage. It's crucial to advocate for her health and ensure she receives the appropriate care.

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