A Question for the DIP Deniers

   
I'm not RA for a long time and I've now worked in a job that exposes me to a lot of news about RA for several years and yet, I still learn new things every day. For instance, the DIP debate.



The DIP is short for the distal interphalangeal joint. Which is the joint on your finger just before the nail.



(And I can't say anything that has the word phalanges in it without thinking "dancing phalanges!")



Anyway, back to the point of the day. For as long as I remember, I've known that swan neck deformities are classic signs of RA. I developed them very early on and most of the people I've met who had RA in their hands and fingers that had not been well controlled also had them. It's similar to secret handshake for people who can't shake hands - a quick glance will tell you whether the other person is "in the club."



And what is this swan neck deformity? The American College of Rheumatology (ACR) has a picture and drawing in their image bank describing that it "may develop as a result of synovitis" (i.e., inflammation of the synovium, the thin layer of tissue that lines the joint and which becomes inflamed and RA). The joints involved include metacarpophalangel distal interphalangeal and proximal interphalangeal joints.



Right. Too many polysyllabic words. Basically, it looks like this (pardon Lucy being indelicate with her toilette in the background):


 

Unmistakable, right? It's pretty clear to me that this can't happen without some sort of RA involvement of the DIP joint.

Except a couple weeks ago, I discovered that there appears to be some sort of debate about this and I made a mental note to do some research. And forgot, because it was a bad fibro day and my brain wasn't working. Then last week, Kelly over at RA Warrior posted about it, nudging my thinking even more. Because guess what? All kinds of people are saying that there is absolutely no DIP involvement in RA. Even Johns Hopkins says so. John's freaking Hopkins! They say that "rheumatoid arthritis does not affect the distal interphalangeal joints."

Maybe I don't have RA after all... Does that mean I'm cured?
   

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