Hand ultrasound help!
Had hand ultrasound done Monday. I will copy my results. I've had extreme issues with my hands for almost 5 years, they originally thought carpal tunnel, but ruled that out in 2020, found c5/6 was bad with degeneration and pinched nerve, replaced that, hands got worse. Rheumatologist insists I don't have arthritis, as bloodwork is off, but had a positive ana, just no specific antibodies. Fast forward to her finally ordering and emg and hand ultrasound. Last emg was 2 years ago, normal, except neck nerve damage. This emg shows carpal tunnel bilateral, so right hand is getting done mid June, then left a month later. Hand ultrasound looks bad (in my eyes,) but she hasn't contacted me yet. Can anyone shed light, as it appears it points to RA. Also, my mom went misdiagnosed for years, as no positive in bloodwork, but she has extreme degeneration now, is disabled, and has extreme damage to hands. The following are my hand ultrasound results. Thank you.
Mild to moderate synovial thickening thickening and small joint effusions
without erosion or hyperemia involving bilateral dorsal radiocarpal and volar
distal radioulnar joints. No extensor tenosynovitis bilaterally. No erosion of
ulnar styloid bilaterally.
Left hand: Moderate synovial thickening with hyperemia involving left second MCP
joint without joint effusion or erosions. Mild to moderate synovial thickening
of the remaining MCP and PIP joints without hyperemia or erosions.
Right hand: Mild to moderate synovial thickening without joint effusion,
hyperemia or erosions involving all MCP and PIP joints.
IMPRESSION:
IMPRESSION:
1. Active inflammation involving left second MCP joint.
2. Mild to moderate synovial thickening and small joint effusions without
erosion or hyperemia involving other bilateral hand and wrist joints,
nonspecific but may be from prior inflammatory arthropathy or degenerative in
etiology.
I have a form of rheumatoid arthritis called seronegative RA. That means that my blood work doesn't really show any signs of RA, not even the ANA or RF factor. So, for me, my doctors had to diagnose my RA based only on what I told them and their experience. Osteoarthritis can also be something, depending on age, but if you are unhappy with the first rheumatologist it may be time to think about getting a second opinion. Unfortunately it is impossible for us to diagnose what's going on from here for a number of reasons, the most important being that everyone is totally different and RA is such a unique illness that it requires the expertise and knowledge of a trained rheumatologist to really diagnose. I know that's not the answer you were looking for but, unfortunately it's the only real way to know. Let us know how it turns out! Keep on keepin' on, DPM
I so wish it wasn’t so common to read stories of struggles to get diagnosed! I’m not a radiologist or rheumatologist, but I will say your US sounds similar to mine at diagnosis. My (former) rheumatologist didn’t believe I had RA until the US was done - and I was sero-positive! RA can cause synovial changes, but isn’t the only cause. By far the good news is no permanent damage in the form of erosions!!! RA typically affects the MCP joints (knuckles where fingers meet hand); OA the PIPs (joints closest to fingertips) and base of thumbs. For those with RA, it is not uncommon to have both RA and OA in our hands. I can attest to the fact they both hurt! I just had a steroid injection in the base of my thumb and it is really helping. I Hope for a diagnosis and treatment plan for you very soon, Jo (moderator)
