Spondylitis Association of America
Hi all! It's been ages since I've posted, and I see lots of new faces around here, plus the entire website has changed dramatically. Very nice!

I have a question. I have AS and am on Humira, after being on Enbrel for several years. A little while ago, on a Friday, I looked down and noticed my knuckle on my right pinky finger looked horribly bruised, all black-and-blue. Yet it did not hurt and there was no noticeable swelling. I found it odd, because I had not banged it, and in the past I've banged my hands badly on things and never gotten a bruised knuckle.

As luck would have it, I had a rheumatologist appointment that very Monday. But I woke up Monday and it had disappeared as mysteriously as it had appeared.

I mentioned it to my doctor anyway. He said it was probably something-I-didn't-understand and that it could be brought on by stress and a few other things, and did not seem really concerned.

Now, usually my doctor is not rushed, but this morning he seemed in a bit of a hurry and when I checked in I overheard the woman at the desk telling another patient "Dr. XYZ called off today, so you'll be seeing (insert my doctor's name here) instead." I get the feeling he was double-booked through no fault of his own, so I did not press the issue for clarification. Normally I would have asked him more questions, which he would gladly answer, but I just sort of let it go (my mistake).

Now I'm curious as to what it was, and I have looked online but "knuckle bruising arthritis" and "knuckle bruising ankylosing spondylitis" yield a mind-numbing number of hits, most of which don't seem to apply at all. Especially since it wasn't so much bruised at all, as discolored.

Does anyone here know what it might have been?
What I'm going to say probably doesn't apply, since infections don't normally go away as suddenly as that...

BUT... the only thing I've had that looked like a bruise, but wasn't... turned out to be a skin infection, near the site of an injection I had. That didn't go away without a course of anti-biotics. It looked like some sort of a wierd black bracelet / tattoo.
Posted By: Anonymous Re: Question about weird bruised look on knuckle - 07/18/09 07:47 PM
was it blue? any white? if you Google Reynaud's Phenomenon does any of it apply? It almost sounds like the blood vessels were loosing their blood supply for a short time. I have a friend who has this Reynaud's, and it comes and goes just like you described, and it is a skin discoloration..but there are other symptoms too. That is a long shot, but it is also an autoimmune disorder, and as you probably know they like to run in packs...I hope it is nothing serious, but please if you get a chance look it up, and even look up Reynaud's under images as well to compare it...I hope it is nothing serious though. Good luck and keep us posted. Hope this helps...

http://medical-dictionary.thefreedictionary.com/Reynaud%27s+phenomenon

Raynaud's Disease:

Definition-
Raynaud's disease refers to a disorder in which the fingers or toes (digits) suddenly experience decreased blood circulation. It is characterized by repeated episodes of color changes of the skin of digits on cold exposure or emotional stress.
When a "new" joint gets attack by the disease, I get bruising there. It is blood at the tendon, which I think you might find hits about. It is caused by mild swelling that bumps the blood vessel. It comes and go and then that joint hurts. My ankles almost always have bruising.

At my knuckles it was about the size of a dime on the size of the joint.

Anna
Thanks for your suggestions. I checked on Raynauds, as that is one of the first things I thought of, but it was just one knuckle and not a whole digit, and it was more purple than blue and white.

I do believe it was auto-immune in nature, but it did not swell or hurt or feel warm, the way an arthritic joint would. I get the feeling it was more to do with the blood vessels in the joint, than the joint itself.

Very strange, and it was a bit alarming. I showed it to my neighbors at work and they all felt it didn't look right.

Lord knows my extremities are about the only joints AS hasn't hit; I hope it stays away from them!
My only thought is temporary broken blood vessel. They dont always hurt and dont last too long and I for some reason always get my middle pinky knuckle. Some how im bumping or exerting pressure. But hey good to hear it dont hurt! thats always a plus.
I occasionally wake up with bruises on my elbows where the tendon attaches to bone. They'll just spontaneously appear on one elbow and then a week later, they'll be on the other. I think it is tendon damage in my case. Maybe the same thing with your finger?
When I get odd looking stuff I often take pictures - since I too have been the victim of the "here today, gone at the doctor's office" phenomenon! It sounds unsettling... but seems several of the folks here have a reasonable answer (the start of a new area of inflammation?) At any rate, I hope it doesn't cause any more worry.
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