Wrist Swelling: Could It Be Rheumatoid Arthritis?

The bones in both wrists are swollen?

Dear Doctor,
Hello.
For the past two months, I have been experiencing discomfort in my left shoulder, feeling stiff and painful in certain positions, making it difficult to lift my arm.
In the last two weeks, I have noticed swelling between my left wrist and palm, which is painful to the touch, and sometimes there is redness, swelling, and heat.
Now, the same swelling has also appeared between my right wrist and palm.
I am finding it increasingly difficult to do laundry and wring out towels.
I have a history of dry eye syndrome and urticaria, and blood tests have ruled out Sjögren's syndrome.

I would like to ask: Is it possible that I have rheumatoid arthritis? How can it be definitively diagnosed? Currently, the symptoms are bearable; should I ignore them and see if they resolve on their own or could they worsen? Should I consult an orthopedic specialist or a rheumatologist? I donated blood ten days ago; can blood from a patient with rheumatoid arthritis be used for transfusion?
Thank you for taking the time to respond.

Nanxi, 50~59 year old female. Ask Date: 2013/10/18

Dr. Gao Jiankai reply Internal Medicine

Hello, Nanxi, thank you for your questions.
Here are the answers to your inquiries:
1.
Is it possible to have rheumatoid arthritis? Answer: Rheumatoid arthritis is a chronic form of arthritis, and since your pain has lasted a maximum of only two months, with wrist pain for only two weeks, it is still uncertain whether it is chronic arthritis.
It is advisable to continue monitoring the situation.
2.
How is it diagnosed? Answer: Time is an important factor.
We will also perform X-rays, blood tests, and assess symptoms to confirm the number of affected joints before making a diagnosis.
3.
Will ignoring it make it worse? Answer: It is difficult to determine without an examination; text alone may not provide enough information.
4.
Which department should I visit? Answer: It is recommended to see a specialist in Allergy, Immunology, and Rheumatology.
5.
Can blood from someone with rheumatoid arthritis be used by others? Answer: As long as the person has not taken medication, it is generally safe, and it will not cause others to develop the same condition.
Changhua Hospital, Ministry of Health and Welfare, Allergy, Immunology, and Rheumatology Department is concerned about your health.

Reply Date: 2013/10/18

More Info

Hello! Thank you for your detailed question regarding your symptoms and concerns about possible rheumatoid arthritis (RA). Based on your description, it seems you are experiencing significant discomfort and swelling in your wrists and shoulders, along with other systemic symptoms like dry eyes and urticaria (hives).

Could It Be Rheumatoid Arthritis?
Rheumatoid arthritis is an autoimmune condition characterized by inflammation of the joints, which can lead to swelling, pain, and stiffness. The symptoms you describe—swelling in the wrists, pain when moving your arms, and the presence of redness and warmth—are indeed consistent with RA. Additionally, the fact that you have dry eyes could suggest a broader autoimmune process, as conditions like Sjögren's syndrome often co-occur with RA.

How to Confirm the Diagnosis
To confirm whether you have rheumatoid arthritis, a comprehensive evaluation by a rheumatologist is essential. This typically includes:
1. Clinical Examination: A thorough physical examination to assess joint swelling, tenderness, and range of motion.

2. Blood Tests: Common tests include:
- Rheumatoid Factor (RF): Often present in RA patients, but not exclusively.

- Anti-Citrullinated Protein Antibodies (anti-CCP): More specific for RA.

- Erythrocyte Sedimentation Rate (ESR) or C-reactive protein (CRP): Indicators of inflammation.

3. Imaging Studies: X-rays or ultrasounds can help visualize joint damage or inflammation.

Should You Wait or Seek Treatment?
Given that your symptoms have persisted and are affecting your daily activities, it is advisable not to wait for them to resolve on their own. Early intervention in RA can significantly alter the disease course and prevent joint damage. If you are experiencing significant pain and functional impairment, seeking an appointment with a rheumatologist would be the best course of action.

Which Specialist to See?
Since your symptoms are joint-related, you should primarily consult a rheumatologist, who specializes in autoimmune diseases and joint disorders. While orthopedic surgeons focus on structural issues and surgical interventions, a rheumatologist will provide a more comprehensive approach to diagnosing and managing autoimmune conditions.

Blood Donation Concerns
Regarding your question about blood donation, individuals with rheumatoid arthritis can often donate blood, provided they are not currently experiencing a flare-up or taking certain medications that might affect blood safety. However, it is always best to check with the blood donation center about specific eligibility criteria related to your health status.

Conclusion
In summary, your symptoms could indeed suggest rheumatoid arthritis, and it is crucial to seek a proper evaluation from a rheumatologist. Early diagnosis and treatment can help manage symptoms effectively and prevent long-term joint damage. Please don’t hesitate to reach out for medical help, as your quality of life is important. Take care, and I hope you find relief soon!

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