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Epicondylitis, Finger Stiffness, Swelling, Pale Hand, Arteries And Veins Bulging, High BP, X-rays, Bone Scan, EMG, Physical Therapy. Diagnosis?

Posted on Wed, 23 May 2012

Question: Hello, I am a 27 year old female. I am 5 ft 3 inches and I weight 135 pounds. 9 weeks ago I experienced an injury to my right elbow. I was first diagnosed with epicondylitis. I am experiencing stiffness in my fingers and wrist as well as swelling in the fingers. I also have been experiencing color changes in my hand. Most of the time it is pale compared to my left hand and the skin texture is different. Sometimes it changes to a blochy color or my whole hand will become completely purple. I also have numbness and tingling in the hand and intense pressure in my fingers. Also the arteries or veins in my hand, wrist and forearm are bulging out. I also have decreased strength in my hand. I also have constant temperature changes in my hand. At times it will be clammy and at times it is very cold. Also since the initial injury my blood pressure has increased significantly. My blood pressure was always a constant 120/70. Now it was been averaging 180/90. I have now been referred to a hand specialist. He ordered x-rays, a bone scan and an emg nerve test. Everything came back normal. He stated that he is unsure what is wrong and just wants me to continue at physical therapy. Can someone please help me and try and give me some idea of what is wrong with me! Thank you so much!!

Answered by Dr. Dr. Rakhi Tayal (18 minutes later)

Hi,

Thanks for writing to us.

From the description you have given it seems that the problem is not in the bones or nerves rather there seems to be a blockage in the veins of your hand secondary to injury or infection. The bulging veins in the arm, color changes in the hand and weakness of hand muscles is suggestive.

For diagnosis, you need to have a vascular study of your hand and arm vessels by color Doppler after which treatment can be advised. The rise in blood pressure may also be related to the vascular problem. A specialist dealing with vascular pathologies like vascular surgeon will be able to help you better.

I hope this information has been both informative and helpful for you. If there are additional concerns, I am available for your followups.

Regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Rakhi Tayal (48 hours later)

Thank you so much for your response. I am having an MRI with contrast tomorrow. Will this test show any vascular issues?

Answered by Dr. Dr. Rakhi Tayal (4 hours later)

Hello.

Thanks for writing back.

MRI with contrast should be able to diagnose your problem, but the best investigation for vascular problems will be a colour doppler, as if there is any blockage in the vascular system, it should be able to pick it up.

All the best for your scans.

Wishing you an early recovery.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar