Differential Diagnosis for Chronic Finger Swelling

Single Most Likely Diagnosis

• Rheumatoid Arthritis (RA): This is a common autoimmune disorder that can cause chronic swelling in the fingers due to inflammation of the joints. The chronic nature of the swelling and the involvement of the fingers make RA a highly plausible diagnosis.

Other Likely Diagnoses

• Osteoarthritis (OA): Although OA is more commonly associated with degenerative changes and less with swelling, certain forms like erosive OA can cause significant swelling in the fingers.
• Psoriatic Arthritis (PsA): This condition combines the swollen, scaly skin of psoriasis with joint pain and arthritis. Finger swelling can be a symptom, especially if the distal interphalangeal joints are involved.
• Gout: Gouty arthritis can cause acute and chronic swelling in the fingers, especially if the condition is not well-managed. Tophi (deposits of uric acid crystals) can form in the fingers, leading to chronic swelling.

Do Not Miss Diagnoses

• Infection (e.g., Osteomyelitis, Septic Arthritis): Although less common, infections can cause chronic swelling and have serious consequences if not treated promptly. These conditions require immediate medical attention.
• Malignancy (e.g., Soft Tissue Sarcoma): Rarely, chronic swelling in the fingers can be a sign of a malignant process. While unlikely, missing a diagnosis of cancer could have devastating consequences.
• Sarcoidosis: This autoimmune disease can cause inflammation in various parts of the body, including the skin and joints, leading to swelling. It's less common but important not to miss due to its systemic implications.

Rare Diagnoses

• Sjögren's Syndrome: An autoimmune disorder that can cause inflammation in the joints and other parts of the body, potentially leading to finger swelling.
• Relapsing Polychondritis: A rare disease that causes cartilage inflammation, which can lead to swelling in various parts of the body, including the fingers.
• Ehlers-Danlos Syndrome: A group of disorders that affect connective tissues supporting the skin, bones, blood vessels, and many other organs and tissues. Some types can cause joint hypermobility and swelling.
• Scleroderma: A chronic disease characterized by excessive deposits of collagen, leading to hardened, tight skin, and potential swelling in the fingers due to sclerodactyly.