Pain and/or swelling in fingers wrists ankles feet

Question

About two months ago I developed tenderness and swelling in the joint of my right middle finger and in the webbing between that finger and my hand. At the beginning of October, an orthopedist gave me an injection to relieve the pain and swelling in the finger instead of putting me on anti-inflammatory medicine because I was having an endoscopy on my pancreas in mid October. I have been diagnosed with chronic pancreatitis. I do not have a history of alcohol abuse and I have never smoked. Since the beginning of October, the swelling and tenderness has gotten worse and it has spread to a few more fingers in both hands. My wrists are tender to the touch and hurt. My ankles hurt, even when I lightly touch them. The bottoms of my feet hurt. I have been wearing a Fentynl patch since my release from the hospital on October 17. Even with this pain medicine, which works on my serious pancreatic pain, it is not provide relief for the pain in my joints. Because pancreatitis is is caused by an inflammation, is there any chance that whatever is causing the inflammation and pain in my joints, could have something to do with my pancreas as well. My internist saw me last week and said he doesn’t know what would cause this type of pain or swelling. I was checked several years ago for lupus because of neuropathy that I have in my lower extremities and fingertips and lower arms, but the exam was was negative. Could anyone make a suggestion on where I should see help?

Answer

You need to be seen by a rheumatologist. Autoimmune pancreatitis is uncommon, but can occur in lupus and rarely in vasculitis. If your pancreatitis is due to lupus, your blood tests should be very positive.

Alan Matsumoto, M.D.

About Alan Matsumoto, M.D.

Part-time Faculty, Division of Rheumatology
Johns Hopkins University