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
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)
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