Rheumatoid Arthritis & the Hand:
28 Hand Signs!
RHEUMATOID ARTHRITIS: HOW TO MAKE A HAND DIAGNOSIS VIA 'MULTI-PERSPECTIVE PALM READING'!
How to make a Palm Reading Assessment for RHEUMATOID ARTHRITIS?
Key-elements of the hand in Rheumatoid Arthritis in a nutshell: multiple motoric problems (featured with sensations of stiffness, numbness, tingling, burning, or pain), usually combined with multiple abnormalities in the fingernails or the finger morphology or the skin.
[Phantom picture for Rheumatoid Arthritis becomes available soon]
An advanced hand diagnosis for Rheumatoid Arthritis requires a person to have multiple significant hand markers that follow the MAJOR REQUIREMENT + the additional requirements described below:
MAJOR REQUIREMENT: The person requires to have significant hand markers for Rheumatoid Arthritis in at least 3 dimensions of the hand
- ADDITIONAL REQUIREMENT A: The person requires to have at least 3 hand markers that relate to MOTORICS (= hand perspective 7)
- ADDITIONAL REQUIREMENT B: The person requires to have at least 2 hand markers that relate to the following three perspectives: FINGERNAILS (= hand perspective 2), FINGER MORPHOLOGY (= hand perspective 3), and SKIN QUALITY (= hand perspective 6).
- ADDITIONAL REQUIREMENT C: The person requires to have at least one hand marker in the palm (or back of the hand) + at least one hand marker in the fingers.
(More specifications will follow soon)
IMPORTANT: Even when all above REQUIREMENTS are fullfilled, then one can still NOT speak of a 'confirmed' hand diagnosis for Rheumatoid Arthritis: additionally, X-rays & lab tests are required for a complete diagnosis!
Some of the 28 significant hand markers for Rheumatoid Arthritis that are listed below became known in medical science as a 'physical minor anomaly' (such as the simian crease & the Sydney line).
But in general most of these individual hand markers can often be described as harmless body characteristics - except for the markers described for perspectives 6 and 7.
- List of 28 hand markers for Rheumatoid Arthritis -
• Hand perspective 1 - HAND SHAPE:
- Prominent wrist bones.
• Hand perspective 2 - FINGERNAILS:
- Uneven nail growth: pronounced longitudinal ridges, dents;
- Nail beading in at least 50% of the nail (nychodystrophy);
- Microinfarcts around the nailfolds / red spots (vasculitis);
- Diffuse reddish lunula;
- Nail clubbing;
- Yellow nail syndrome.
• Hand perspective 3 - FINGER MORPHOLOGY:
- Sausage-shaped swelling of the fingers;
- Swollen, red, warm finger joints;
- Shift in position of the fingers: angulation or collapse;
- Deformity in which the middle finger joint becomes bent (Boutonniere deformity);
- Deformity where end of finger is bent and middle joint over extends (Swan-neck deformity).
[+ for OSTEOARTHRITIS: low '2D:4D digit ratio'].
• Hand perspective 4 - MAJOR LINES:
- Simian crease;
- Sydney line.
• Hand perspective 5 - DERMATOGLYPHICS:
- Tented arches.
• Hand perspective 6 - SKIN QUALITY:
- Firm nodules along the fingers;
- Small cysts cyst on the fingers (mucous cyst);
- Soft lump on back of hand that moves as fingers straighten.
• Hand perspective 7 - MOTORICS:
- Combination of stiffness, swelling & pain in multiple fingerjoints of both hands;
- Morning stiffness > 1 hour;
- Morning pain: "dull" or "burning" sensation;
- Rainy weather pain;
- Creaking sound during finger movement (crepitus);
- Locked finger, a.k.a. 'trigger finger' (stenosing tenosynovitis);
- Loss of finger mobility to straighten the hand;
- Unstable joints in the wrist, fingers, and thumb;
- Numbness, tingling and/or pain in the hand (carpal tunnel syndrome);
- In advanced stages, surrounding joints may become more mobile than normal;
- 'Motoric hand index' < 3 [= (open hand span - closed hand span)/lateral height of the hand].
NOTICE: About 1% of the world population has rheumatoid arthritis - though up to about 20% of people have complaints that relate to symptoms of rheumatoid arthritis.
- MORE MULTI-PERSPECTIVE PALM READING -
The hand in DIABETES MELLITUS
The hand in PSORIASIS
The hand in DOWN SYNDROME
The hand in FRAGILE-X SYNDROME
Fingernails problems in Rheumatoid Arthritis
|
THE FAMOUS 'SIMIAN LINE' (SINGLE PALMAR CREASE) IS ONLY A MINOR KEY-ELEMENT FOR THE HAND IN RHEUMATOID ARTHRITIS
Hand Diagnostics:
the Simian Line & Rheumatoid Arthritis!
Various studies around the world have proven that the simian line is more often seen among people who have Rheumatoid Arthritis than in the general population (about 3% of the healthy population has a simian line in at least one hand).
This implicates that the simian line is much more important in the genetic syndromes (e.g. Down syndrome & Fragile-X syndrome) than it is in Rheumatoid Arthritis.
Therefore a simian line can only play a role in a hand diagnosis for Rheumatoid Arthritis if multiple significant hand markers are seen in two other perspectives (MOTORICS + FINGERNAILS/FINGER MORPHOLOGY/SKIN QUALITY).
This raises the question: 'how can the simian line serve as a diagnostic marker specific for Rheumatoid Arthritis?'
'Phantom picture' of the hand in Rheumatoid Arthritis.
NOTICE: Later the author will present a comprehensive 'phantom picture' for the most typical hand-characteristics in Rheumatoid Arthritis.
HAND LINES IN RHEUMATOID ARTHRITIS:
• 1 - Simian crease
|
Prevalence: Rheumatoid arthritis patient: males: 16.7-20.2 %, females: 3.1-25.0 %; controls: 8.2-14.1 % & 1.0-9.6 % 1,2
|
|
• 2 - Sydney line
|
Prevalence: Rheumatoid arthritis patients - males: 5.3-8.3 %, females: 0.0-5.2 %; controls: 3.6-4.2 % & 1.6-3.1 % 1,2
|
|
(More details about prevalence of other significant hand markers for diabetes - plus the relates sources - will become available later)
SOURCES:
1) Can Dermatoglyphics be used as an Anatomical Marker in Egyptian Rheumatoid Patients? H.M. Elsaadany, et al., 2010
2) Dermatoglyphic Characteristics of Patients with Rheumatoid Arthritis. Sung-Bae Hwang, et al., 2005