Doctor, I Have a Lump on a Finger Joint… Could It be Arthritis?

Finger joint lumps and bumps can be disfiguring and a cause of great concern for the patient. Here are some potential causes.

Osteoarthritis, the most common form of arthritis, often affects the hands. When it does, it often causes local inflammation of the distal interphalangeal joints (DIP or last row) and proximal interphalangeal joints (PIP or next to last row). This inflammation causes the joints to swell and hurt. The lumps that form are called Heberden’s nodes (DIP) and Bouchard’s nodes (PIP). Involvement of the base of the thumb may also cause a lumpiness or squared-off appearance.

Gout also causes lumps in the fingers. Gout may cause inflammation of the interphalangeal joints of the fingers. When this occurs, it may be indistinguishable from a flare of osteoarthritis. Middle-aged (post-menopausal) or elderly women on diuretic therapy are particularly prone to developing this. Gout may also cause soft tissue lumps. The diagnosis is made by aspiration of fluid from the affected joint or soft tissue mass with examination of the aspirated material using polarizing microscopy.

Rheumatoid arthritis causes joint swelling involving the wrists, metacarpophalangeal (MCP) joints (knuckles) as well as the PIP joints. Inflammation may lead to lumpiness. Rheumatoid arthritis also causes rheumatoid nodules to develop in the finger joints. These nodules occur in patients with long-standing and severe disease.

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