2 finger knuckles: Two Finger Knuckle | Etsy


Thin Cord Knuckles, Black

Thin Cord Knuckles in a black finish. This is a shiny thin knuckle that has a paracord wrapped palm brace. The knuckles have protruding edges. Has four finger holes that can fit any finger size.

Thin Cord Knuckles, Black

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Thin Cord Knuckles, Black, PAIR

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Beware of “Knucks,” “Novelty Bottle Openers,” and Other “EDC Pocket Tools” |

Photo: Brass knuckles carried by Lincoln’s bodyguards during his train ride through Baltimore (Highsmith (Carol M.) Archive at the Library of Congress)

A growing trend within the everyday carry (“EDC”) community is something called a “knuck.” Knucks are essentially redesigned brass knuckles made to fit one or two fingers instead of all four. Also called “knuckles,” knucks are marketed and purchased primarily as EDC self-defense weapons.

The growing popularity of knucks, as well as all things EDC, has resulted in dozens of small businesses popping up that design, manufacture, and sell knucks. Rather than looking like the cheap brass knuckles you find at a flea market, these modernized knucks are often multipurpose (the most common modification is a bottle opener) and are made of metals ranging from titanium and stainless steel to copper and aluminum.

While many companies and individuals refer to these creative works of art as novelty bottle openers, pocket tools, multipurpose tools, keychains, and paper weights, at their core knucks are self-defense weapons. Regardless of what you or the person you bought them from calls them, knucks are subject to North Carolina’s criminal law statutes which make it illegal to carry concealed weapons.

Are Brass Knuckles Illegal in North Carolina?

In North Carolina, it is illegal to carry brass knuckles if they are carried concealed. See N.C. Gen. Stat. § 14-269. This applies to all types of metallic knucks or knuckles regardless of how many fingers they fit. This statute does not make it illegal for someone to possess brass knuckles or carry them concealed on their own premises.

If you’re in North Carolina and are carrying one of these metallic knucks, EDC pocket tools, or novelty bottle openers in your pocket (or somewhere else about your person which conceals the weapon), then you are illegally carrying a concealed weapon. This is the case even if you have a concealed handgun permit because such a permit applies to handguns, not other weapons like knucks. See N.C. Gen. Stat. § 14-415.10 et. seq.

Anyone found guilty of carrying a weapon such as brass knuckles in a concealed manner in violation of N.C. Gen. Stat. § 14-269(a) shall be guilty of a Class 2 misdemeanor. A Class 2 misdemeanor provides for a maximum penalty of 60 days in jail and a $1,000 fine.

If you have been charged with carrying a concealed weapon in Winston-Salem or other surrounding county in North Carolina, contact Allman Spry today to schedule a consultation with a dedicated North Carolina criminal defense lawyer.

Brass Knuckles Legality By State 2021

Brass knuckles are typically treated like other weapons such as knives and firearms in other countries.

Brass knuckles are illegal in many countries, including Hong Kong, Austria, Belgium, Bosnia, Canada, Croatia, Cyprus, Finland, Germany, Greece, Hungary, Ireland, Israel, Malaysia, the Netherlands, Norway, Poland, Portugal, Russia, Spain, Turkey, Singapore, Taiwan, and the United Kingdom.

Some countries have specific regulations on brass knuckles. For example, in Serbia, brass knuckles are legal to purchase for people over 16 years old but cannot be carried in public.

In the United States, there are no federal laws regulating brass knuckles; however, there are various states, county, and city laws that prohibit their sale or possession. Brass knuckles can typically be purchased at markets or from companies that make belt buckles and other metal goods (where legal).

Brass Knuckle Laws by State


Brass knuckles are not illegal in Alabama. Carrying brass knuckles in a concealed manner is Illegal in Alabama. You must obtain a permit to carry a concealed weapon. Failing to adhere to this law can result in a misdemeanor.


According to Sec. 11.61.210. “A person commits the crime of misconduct involving weapons in the fourth degree if the person… manufactures, possesses, transports, sells, or transfers metal knuckles.


In Arizona, individuals over 21 can legally carry a concealed firearm or deadly weapon without a permit. Brass knuckles are typically considered to be a deadly weapon. The use of brass knuckles can still result in a felony charge.


Brass knuckles are illegal in Arkansas. This includes selling, brandishing, exhibiting, repairing, manufacturing, and possessing brass knuckles. Charges can either be a misdemeanor or felony, depending on the scenario in which the law was broken and how severe the consequences were.


California imposes a strict ban on all kinds of brass knuckles, whether they are metal or plastic. This includes selling, buying, using, carrying, repairing, lending, and manufacturing. Breaking this law lands an individual in either California State Prison or Jail.


Brass knuckles are illegal in Colorado. This includes brass knuckles that are used as jewelry, accessories, or anything else exhibiting them. Failing to adhere to this law can land an individual a $1,000 fine and one year of imprisonment.


Brass knuckles are not illegal in Connecticut; however, it is illegal to carry them concealed. One will need to have either a license or a permit to do so. Failing to adhere to this law will result in a misdemeanor.


It is illegal to carry brass knuckles in Delaware without a concealed carry permit. First-time violations of this law lead to felony charges.

District of Columbia

Brass knuckles are illegal in Washington DC. This includes brass knuckles that are used as jewelry, accessories, or anything else exhibiting them. Among some other weapons, Brass knuckles may be possessed by on-duty military personnel, sheriffs, prison wardens, police officers, and some other select professions.


Brass knuckles are not illegal in Florida, but you must have a license or permit to carry a concealed weapon if you wish to carry them hidden or concealed. Failing to do so can result in a misdemeanor charge punishable by up to $1,000 in fines and three years in prison.


Brass knuckles are legal to own and carry in Georgia. Using the brass knuckles to injure another person is a criminal act and one cannot carry brass knuckles in schools or hospitals.


Brass knuckles are legal to sell and possess but cannot be carried or stored in one’s vehicle. Failure to adhere to this law will result in a misdemeanor.


The law in Idaho does not specifically state whether brass knuckles are legal or not. However, brass knuckles can be considered a dangerous weapon; therefore, it is up to the courts to determine this and how the knuckles were used, and if the owner had criminal intent.


Brass knuckles of any type and material are prohibited in Illinois. This includes anything shaped like a brass knuckle, including jewelry, bags, pendants, or necklaces. Carrying or owning brass knuckles is illegal in Illinois, and using brass knuckles to injure is a felony charge.


Brass knuckles are legal to own and carry in Indiana. Brass knuckles are not specifically labeled as a dangerous weapon under Indiana law; however, it is illegal to use them in an act of violence.


The law in Iowa does not specifically state whether brass knuckles are legal or not. However, brass knuckles can be considered a dangerous weapon; therefore, it is up to the courts to determine this and how the knuckles were used, and if the owner had criminal intent.


Brass knuckles are strictly prohibited in Kansas. This includes selling, brandishing, exhibiting, repairing, manufacturing, and possessing brass knuckles. Charges can either be a misdemeanor or a felony, depending on the scenario in which the law was broken and how severe the consequences were.


Kentucky requires a license to carry a concealed deadly weapon anywhere other than an individual’s own property, including brass knuckles. Carrying a concealed weapon without a license is considered a Class A misdemeanor, resulting in up to 12 months in jail and a fine of up to $500.


Louisiana allows the carrying of concealed weapons, such as brass knuckles, as long as the individual has a legal permit to carry a concealed weapon.


Brass knuckles are illegal in the state of Maine.


Brass knuckles are not illegal in Maryland; however, it is illegal to carry them hidden or concealed unless you have a license or permit to carry concealed weapons. Failure to adhere to this law will result in a misdemeanor and lead to a fine of up to $1000 and up to three years of imprisonment.


Brass knuckles are illegal in Massachusetts. This includes possession, sale, and manufacture of brass knuckles. Failure to adhere to this law will lead to a fine between $50 and $1000 or up to six months of imprisonment.


Brass knuckles of any type and material are prohibited in Michigan. This includes anything shaped like a brass knuckle, including jewelry, bags, pendants, or necklaces. Manufacture, sale, or possession of brass knuckles are felony charges that lead to a fine of up to $2500 and imprisonment of up to five years.


Brass knuckles are strictly prohibited in Minnesota. This includes selling, brandishing, exhibiting, repairing, manufacturing, and possessing brass knuckles. Charges can either be a misdemeanor or a felony, depending on the scenario in which the law was broken and how severe the consequences were.


Brass knuckles are not illegal in Mississippi; however, it is illegal to carry them hidden or concealed, whole or in part. The first offense is punishable by a fine of $100 to $500 and/or up to six months of jail.


Brass knuckles are strictly prohibited in Missouri. This includes selling, brandishing, exhibiting, repairing, manufacturing, and possessing brass knuckles. Violation of this law can result in a Class D felony charge with up to four years in prison.


The law in Montana does not specifically state whether brass knuckles are legal or not. However, brass knuckles can be considered a dangerous weapon; therefore, it is up to the courts to determine this and how the knuckles were used, and if the owner had criminal intent.


Brass knuckles are legal to own in Nebraska; however, they are illegal to carry concealed unless the individual has a license or permit to do so. Certain places, such as churches, schools, and bars, prohibit concealed weapons even with a permit. Business owners have the right to prohibit weapons inside their business regardless of whether an individual has a permit or not. Failure to adhere to this law will result in a misdemeanor.


Brass knuckles are illegal in Nevada. This includes selling, brandishing, exhibiting, repairing, manufacturing, and possessing brass knuckles. Failure to adhere to this law results in a misdemeanor leading to fines of up to $2,000 and/or up to one year in prison.

New Hampshire

It is illegal to sell and carry brass knuckles in New Hampshire. Failure to adhere to this law results in a misdemeanor punishable by up to $2,000 in fines and up to one year in prison.

New Jersey

Brass knuckles are illegal to possess and carry in New Jersey. However, one may possess brass knuckles for lawful purposes such as for theater productions, personal collections, or other educational or entertainment purposes. Failure to adhere to this law, even if carrying in case of self-defense, will result in a felony with up to $10,000 in fines and up to 18 months in jail. If one is caught with brass knuckles with unlawful intent, the punishment increases to a fine of $15,000 and three to five years in prison.

New Mexico

Brass knuckles are not illegal in New Mexico; however, it is illegal to carry them hidden or concealed unless you have a license or permit to carry concealed weapons. Failure to adhere to this law will result in a misdemeanor and lead to a fine of up to $1000 and up to three years of imprisonment.

New York

Brass knuckles are illegal in New York. This includes both metal and plastic knuckles. Failure to adhere to this law will result in a misdemeanor and up to one year of imprisonment.

North Carolina

Brass knuckles are not illegal in North Carolina; however, it is illegal to carry them hidden or concealed unless you have a license or permit to carry concealed weapons. Failure to adhere to this law will result in a misdemeanor and lead to a fine of up to $1000 and up to three years of imprisonment.

North Dakota

Brass knuckles are not illegal in North Dakota; however, it is illegal to carry them hidden or concealed on one’s person or in one’s car without a permit. Even with a permit, concealed weapons are prohibited in certain places, such as liquor stores or public gatherings. Failure to adhere to this law will result in a misdemeanor charge.


Ohio’s law state that the use and possession of a deadly weapon are illegal, but brass knuckles are not specifically mentioned. Brass knuckles, however, can be considered a deadly weapon, so one should use caution. Carrying a concealed weapon without a concealed carry permit is illegal and can result in fines and imprisonment.


Unless in accordance with the Oklahoma Self Defense Act, it is illegal to carry an offensive weapon, including brass knuckles. Failure to adhere to this law will result in a misdemeanor charge.


Brass knuckles are not illegal in Oregon; however, it is illegal to carry them hidden or concealed unless you have a license or permit to carry concealed weapons. Failure to adhere to this law will result in a misdemeanor and lead to a fine of up to $1000 and up to three years of imprisonment.


Brass knuckles are illegal in Pennsylvania. This includes selling, possessing, carrying, purchasing, manufacturing, repairing, and transporting brass knuckles, whether they are made from metal or plastic. Failure to adhere to this law will result in a misdemeanor charge punishable by up to five years in prison.

Rhode Island

Brass knuckles are illegal to possess and carry in Rhode Island. Failure to adhere to this law will result in a misdemeanor with fines up to $1,000 and up to one year of incarceration.

South Carolina

Brass knuckles are legal in South Carolina, and one does not need a concealed carry permit. Brass knuckles are not allowed in schools or hospitals. It is illegal to possess brass knuckles if they are used with the intent to commit a crime.

South Dakota

Brass knuckles are legal in South Dakota. One may carry brass knuckles in a concealed manner unless they are being concealed with the intent to harm. Doing so will result in being charged with a felony.


Brass knuckles are strictly prohibited in Tennessee. This includes selling, brandishing, exhibiting, repairing, manufacturing, and possessing brass knuckles. Charges can either be a misdemeanor or a felony, depending on the scenario in which the law was broken and how severe the consequences were.


As of September 1st, 2019, it is legal in Texas to possess and brass knuckles for self-defense purposes. Previously, carrying or possession was a misdemeanor punishable up to $4,000 in fines or up to one year in jail.


The law in Utah does not specifically state whether brass knuckles are legal or not. However, brass knuckles can be considered a dangerous weapon; therefore, it is up to the courts to determine this and how the knuckles were used, and if the owner had criminal intent.


Brass knuckles are illegal to possess, use, or sell in Vermont. Failure to adhere to this law will result in a misdemeanor with fines up to $1,000 and up to five years of imprisonment.


It is illegal to carry brass knuckles in Virginia without a concealed weapon permit. Failure to adhere to this law will result in a misdemeanor punishable by up to $2,500 in fines and up to one year in prison. Second-time offenders will face a felony charge.


Brass knuckles are illegal in Washington. Possession, distribution, or manufacturing of brass knuckles is seen as a gross misdemeanor punishable by fines up to $5,000 and up to one year in prison.

West Virginia

It is illegal to carry brass knuckles in West Virginia without a concealed weapons permit. Failure to adhere to this law will result in a misdemeanor punishable by fines up to $1,000 and up to one year in prison.


In Wisconsin, brass knuckles are not illegal to own in one’s home; however, brass knuckles cannot be carried concealed without a concealed carry permit. Failure to adhere to this law will result in a Class A misdemeanor.


In Wyoming, brass knuckles are not illegal to possess, but it is illegal to carry a concealed weapon. Failure to adhere to this law will result in a misdemeanor punishable by fines up to $750 and up to six months in prison.

KNUCKLES DUSTER™ TWO – VR Controller Ergonomic Comfort MOD fitting the Valve Index® – betaForm.shop

Experience the exclusive German engineering and Automotive design of the KNUCKLES DUSTER™ TWO, featuring sculpted surfaces and refined geometry for ergonomic comfort during gameplay and simulations.

The grip was developed bridging the gap between the Virtual World and your VALVE INDEX®* VR Controller**

From the enhanced Grip Button Function and Thumb Rest to the Bottom Strap Guide the hard wearing Soft-touch Silicone will ensure a clean and comfortable grip.

  • Maximum comfort for medium & large hands see hand chart
  • Includes a Right & Left Grip presented in an elegant package (see pictures)
  • Colour: Graphite Gray
  • Detailed instructions & further info on: KD2 – Details

• VERY IMPORTANT • to work properly, the valve controller needs to dynamically re-calibrate with the grips on. The recommended way is to:

  1. Putting the Grips on when controllers are turned off.
  2. Drum fingers: When it powers up, hold it with 3rd(middle), 4th(ring) and 5th(pinky) finger and let go of the 2nd(index) finger and your thumb (lift them up). Make sure you hold the controller with the 3 fingers tightly. Start your finger drum see video instruction.
  3. If needed, restart the controller and repeat a few times until re-calibrated.



**Controller not included

*All product and company names are trademarks™ or registered® trademarks of their respective holders. Use of them does not imply any affiliation with or endorsement by them. VALVE INDEX® is a  trademark of Valve Corporation

Please keep in mind the longer shipping times due to COVID-19. You will be kept informed on your order status via email. Follow us on Twitter. #KD2

Finger Arthritis: Signs, Symptoms, and Treatment

Our fingers are important! We use them constantly, all day long: to brush our teeth, to send emails, to cook our meals. When our fingers don’t work the way we want them to, everyday tasks like these become difficult and painful. So what can we do when our finger joints begin to fail?

This article provides more information about arthritis in the fingers, what causes it, and what you can do to help keep your fingers moving.

Verywell / Cindy Chung

Types of Finger Arthritis

There are three types of arthritis that commonly affect the fingers:

  • Osteoarthritis: Osteoarthritis, also called wear-and-tear arthritis, is the most common type of finger arthritis. Osteoarthritis causes normal cartilage to wear away. This exposes bare bone at the joints. The most frequently affected joints in the hand are the knuckles of the mid-finger and fingertip (the PIP and DIP joints) and the joint at the base of the thumb.
  • Rheumatoid arthritis: Rheumatoid arthritis causes a different type of joint destruction. Rheumatoid arthritis is an autoimmune condition that affects the whole body.  It causes the immune system to attack the soft tissues surrounding the joints. The most commonly affected joints in the hand are the knuckles at the base of the fingers (the MCP joints).
  • Gout: Gout is a condition that occurs when crystals develop within the joints. These crystals can form in one or more joints when there is too much of a substance called uric acid in the body. While the big toe is the most commonly affected part of the body, gout can also develop in finger joints.

Rarely, other types of arthritis can also cause problems in the fingers.

Finger Arthritis Symptoms

Symptoms of finger arthritis include:

Patients with osteoarthritis often develop lumps or nodules around the knuckles of the fingers. These lumps are called Heberden’s nodes (when around the knuckle closest to the fingertip) or Bouchard’s nodes (when around the middle knuckle).

These lumps are actually bone spurs around the joints. They can make the knuckles enlarged, swollen, and stiff. People often complain that their rings do not fit or can’t be removed.

Patients with rheumatoid arthritis often have similar symptoms. However, rheumatoid arthritis can actually cause deformities in the hands. Inflammation in the joints can cause finger joints to become crooked and bend away from the thumb.


A joint is the part of your body where two bones come together. Bones are cushioned by cartilage, which allows smooth movement between the adjoining bones. When the cartilage is damaged, arthritis develops.

When our fingers can’t bend and move like we expect, our daily activities become difficult.


Early treatments of finger arthritis are focused on managing the symptoms in an effort to avoid surgery. Treatment options include:

  • Anti-Inflammatory medications: These medications can help treat the pain of finger arthritis, and also help decrease inflammation and swelling around the joints. While you should always check with your doctor before starting any new medication, these are often recommended for joint pains in the fingers.
  • Joint supplements: Joint supplements consist of glucosamine and chondroitin, two of the major building blocks of normal cartilage. These supplements are very safe to use, although the clinical data to support their use is weak. That said, many people say they find them helpful.
  • Cortisone injections: Cortisone is a powerful anti-inflammatory steroid medication and can be useful in limited applications in the hand. While cortisone injections are generally not good to perform frequently, an occasional shot may help calm a flare of arthritis.
  • Hand therapy: Hand therapy, usually performed by an occupational therapist, is helpful to maintain motion and prevent stiffening of the joints.
  • Ice and heat treatment: Joint stiffness and range of motion can be improved by ice and heat treatments. Most people with finger arthritis find warming the hands with a warm washcloth or in moderately hot water is most helpful at relieving the stiffness of arthritic fingers.
  • Splints: Splinting helps to relax and rest the joints. Splinting should be done for limited periods of time to allow for relief without allowing the joint to stiffen.


If these treatments fail to relieve symptoms, surgery may be necessary. In the fingers, several procedures may be done. Your doctor may recommend removing bone spurs, or even fusing or replacing the joint.

The most common surgery is a finger joint fusion. This procedure holds the knuckle in a fixed position to prevent any further motion of the joint. While the joint is then stiff forever, the pain is usually alleviated. During this procedure, your doctor can also straighten any deformity and remove bone spurs.

Finger joint replacement can be a very effective procedure for some people. An artificial finger joint can maintain mobility of the joint without the pain of arthritis. Deformities and bone spurs can also be treated during this surgical procedure.

In general, finger joint replacement is only considered for more sedentary or elderly individuals, as the artificial joints are not designed for strenuous activity or heavy labor. The implants, which may be made of metal, plastic, ceramic, or a combination of materials, can wear out over time and need to be protected from too much activity.


There are several types of finger arthritis that can be painful and limit your daily activities. If you are experiencing joint pain, stiffness, or swelling in your hands, talk to your doctor about your concerns. They can help determine whether arthritis is to blame, and help you manage your symptoms so they don’t get worse.

VIDEO: Photographer Arrested for 2-Finger Ring Police Say is Brass Knuckles – Union Square – New York

Andre PerryView Full Caption

UNION SQUARE — It’s a crime of fashion.

A Brooklyn photographer was arrested for weapons possession in the Union Square subway station for sporting a two-finger ring that investigators said was a set of brass knuckles, court documents say.

And Andre Perry, a 32-year-old Bed-Stuy resident and commercial photographer who shot ads for Reebok, Brooklyn Circus and Nordstrom Men’s, says undercover investigators railroaded him by using a hypothetical statement — that he “could” hurt someone with the ring — against him.

Rings being considered weapons made headlines in 2012 when rapper 2 Chainz was arrested at LaGuardia Airport for a four-finger ring that police considered a weapon. The charge was later changed to a violation and the case was sealed.

Andre Perry Films His ArrestView Full Caption

Andre Perry

Perry was near the stairs leading to the N/Q/R platform on Nov. 19 when the officers, including one who has a suit pending against him for another weapons arrest case, stopped him and began questioning him about the ring.

Perry, who was on his way to his office in SoHo, said he tried to explain that the $30 Dallas & Dynasty ring, which he bought at a Williamsburg flea market, was a fashion accessory.

But the officers said the ring was equivalent to “brass knuckles” and arrested him just before 2:30 p.m., records show. 

“The officer approached me as if I was a threat to society,” an outraged Perry told DNAinfo New York. 

“It made me very upset when I was being held in jail. I was sitting next to people who actually committed crimes. I bought this ring with the intent of wearing it as jewelry. I’ve been wearing it for over a year, and never had a problem.”

Perry used his phone to record NYPD Officer Jonathan Correa confiscate the ring and arrest him.

Just before Perry started filming, Correa asked him if he knew that the ring could hurt someone, and Perry responded, “Yes, but I can also hurt someone with my hand, or just my fist,'” Perry told DNAinfo.

Perry was charged with two counts of criminal possession of a weapon, one for having the ring and the other for “intent to use it unlawfully against another,” according to the criminal complaint from the Manhattan District Attorney’s office. 

The two-sentence criminal complaint quotes Correa as saying, “When I asked the defendant [Perry] about the metal knuckles, he said in substance, ‘I know I could hurt someone with it.'”

Perry was released without bail and is planning to hire criminal defense attorney Mark Bederow before his next court date on Jan. 13, 2015.

Bederow said there is no clear legal definition of brass knuckles, but it should not include rings like the one Perry was wearing.

“A fashionable person wearing a two-finger flat, gold ring marketed and sold as legitimate jewelry, and worn exclusively as such, should not be treated as a criminal accused of being in possession of a weapon,” Bederow told DNAinfo.

“A case involving the legitimate possession of jewelry, which arguably looks like metal knuckles, screams out for the use of prosecutorial discretion and the dismissal of all criminal charges.

The NYPD did not respond to requests for comment, and the Manhattan District Attorney declined to comment.

Dallas & Dynasty, which sells many one- and two-finger rings, did not respond to a request for comment.

This isn’t the first time Correa, who won a physical fitness award when he graduated from the Police Academy in 2010, was accused of making an inappropriate weapons possession arrest. 

Correa and the NYPD were sued in federal court in October by Joseph Cracco, who was arrested by Correa one year earlier for allegedly carrying a gravity knife.

Cracco, a chef who said his folding knife was legal and he used it to open boxes, claims Correa unlawfully arrested him on criminal possession of a weapon charges in the subway at Grand Central on Oct. 18, 2013.

“I was treated as a criminal for having an ordinary pocket knife that I used in my job as a chef,” Cracco said in an email to DNAinfo. “Officer Correa tried very hard several times to flick the knife open by centrifugal force so that he could call it a gravity knife and charge me with a crime. It took him half a dozen tries before the knife would open that way.”

Cracco fought the charges in criminal court but wound up pleading guilty to a lesser charge of disorderly conduct in July 2014 to avoid the ongoing legal costs, according to the lawsuit.

The lawsuit is ongoing. Correa could not immediately be reached for comment and the Patrolmen’s Benevolent Association did not immediately comment. The city Law Department, which handles cases against the city, did not immediately comment.

Perry, who is represented by the Legal Aid Society, is still fighting his criminal case but is also considering filing a federal lawsuit. He initially tried to raise $6,000 on Kickstarter to help him hire a private criminal defense lawyer, but he wasn’t able to raise enough so he’s planning to pay for the legal fees himself. If prosecutors push ahead with the charges, Perry plans to sue the city, he said.

“The end goal is for police officers to think twice before making an arrest,” Perry said. “Whether they’re white or black, I really want them to use discernment.”

Perry was previously arrested in Cobble Hill last March for trying to walk out of an Urban Outfitters at 166 Atlantic Ave. with a pair of camp socks without paying for them. He was charged with petit larceny and criminal possession of stolen property and received a desk appearance ticket, according to the Brooklyn District Attorney’s office. He is due back in court in January.

“I took something that wasn’t mine,” Perry said. “I’m willing to admit when I make a bad decision, but I really got arrested for wearing a ring?”

Rheumatoid Arthritis: Signs & Treatment


To diagnose rheumatoid arthritis, your doctor will examine your joints. He/she will do a full physical exam to look for other signs, symptoms or problems. There may be joints that don’t currently hurt but could be starting to be affected. Your doctor will assess the impact of the arthritis on your life and activities. The appearance of the hands and fingers helps to diagnose this type of arthritis.

X-rays will show certain characteristics of rheumatoid arthritis. These include narrowing of the joint space or erosions of the bone. If your doctor suspects rheumatoid arthritis, he or she may obtain blood tests to suggest the diagnosis. Some common labs that are ordered include erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). These tests measure for any inflammation in the body. Some other tests include rheumatoid factor and anti-CCP antibody. These are more specific to rheumatoid arthritis. Other tests such as antinuclear antigen (ANA) or Lyme’s disease tests may be ordered to ensure something else is not causing the joint swelling or pain.


Rheumatoid arthritis is usually treated with medication. Typically, medications for this condition are prescribed by your primary care provider or a rheumatologist. There may be both oral and injectable medications. Some are considered disease-modifying antirheumatic drugs (DMARDs). Many of these medications are powerful in reducing inflammation and protecting the joints against irreversible injury. However, since they often act on the immune system, they have side effects that may put you at risk of infection. They must be monitored carefully by your health care provider. They are used when symptoms are severe and multiple joints are affected.

Steroid injections (also known as a cortisone shot) are sometimes helpful to manage a “flare” of rheumatoid arthritis when the new pain is limited to one or a few joints.

Surgery may be needed to relieve pain or improve function, but it is not needed in all cases of rheumatoid arthritis. Surgery is often used when medications have failed and the joint is chronically painful, stiff, deformed, or a tendon has ruptured. Less patients require surgery for rheumatoid arthritis now that better medications exist. By using medications prescribed by your doctor and treating this condition early, it often helps reduce the chance you will need surgery. Your rheumatologist and hand surgeon will work together to determine if and when surgery is needed. Surgery can be very effective to fuse or replace a joint or repair a tendon.

© 2020 American Society for Surgery of the Hand

This content is written, edited and updated by hand surgeon members of the American Society for Surgery of the Hand. Find a hand surgeon near you.

90,000 Pain and numbness in the fingers may indicate serious illness

Photo: coalcreekpt.com

Many people complain of numbness in their fingers and pain that wakes up at night and interferes with full work. However, not everyone goes to the doctor when the disease has not gone so far, and irreversible changes can be avoided. About what symptoms should cause concern, and in what cases surgical intervention is necessary, we talk with the orthopedic traumatologist of the Medical Diagnostic and Treatment Center Simonas SYAREIKA.

What diseases of the hand and wrist are most often treated by patients?

– These are mainly diseases caused by pinched nerves – tunnel syndromes of the carpal and ulnar canals, as well as diseases caused by inflammation of the tendons – the so-called “clicking” finger and tenosivitis of the radius. Often there are joint diseases, pain in the hand, and disorders of the subcutaneous structure.

The most common and well-known carpal tunnel syndrome is carpal tunnel syndrome.That is, compression of the median nerve under the transverse wrist ligament, which occurs between the three bony walls and the dense ligament that hold the tendons of the muscles that flex the fingers and hand. Carpal tunnel syndrome and diseases caused by inflammation of the tendons are more often diagnosed in women over 50 or in young people who are burdened with hard physical work. They cannot sleep at night due to numbness and pain in their fingers. During the holidays, these symptoms are most likely to improve. Wrist pain sometimes occurs after an injury, gradually worsens and begins to interfere with daily life.Ulnar canal syndrome affects both men and women over the age of 30. Dupuytren’s contracture (palmar fibromatosis) – a painless scarring and shortening of the palmar tendons – is inherited, more often observed in smokers, physically working men over 60 years old.

– How are the symptoms of these diseases different?

– With carpal tunnel syndrome fingers go numb at night, pain appears in 1-4 fingers, in the morning they are constrained.At the initial stage, the numbness after waking up disappears, with the progression of the disease it remains, and objects begin to fall out of the hands, it becomes difficult for the patient to button up the buttons, although at night there may be no pain at all.

Elbow syndrome most often manifests itself only in numbness of the fingers, less often in pain at night. 4-5 fingers are damaged. With the progression of the disease, the muscles of the palm weaken, strength goes away.

The main cause of stenosing tenosynovitis (“clicking” finger) is pain in the hand.The palm begins to ache when the fingers move. The pain spreads to the forearm. With the progression of the disease, it becomes more difficult to unbend the finger, it “gets stuck”, a characteristic sound appears – a click, which gave the popular name to this disease. Sometimes the finger does not bend at all, then it has to be returned to its place with the other hand. Snap finger syndrome is caused by a nodule in the extensor tendon. Most often, patients are damaged 1, 3, 4 fingers.

Dupuytren’s contracture is manifested by the inability to straighten the fingers, knotty compaction of the skin on the palms.At first it can be painful, then changes occur in the fingers – it is not possible to straighten them.

Hygroma of the wrist (hernia) is a small, rounded bulge under the skin. It occurs as a result of a sharp turn with a load or after a lot of physical exertion. Because of this formation, patients most often turn to a hand surgeon. A “bump” grows on the brush, it frightens people very much.

Diseases of the joints of the hand and wrists are very complex, so a thorough examination is necessary.

– What is the cause of this or that disease?

– The most common cause is excessive physical exertion or injury, as a result of which the tendons become inflamed, enlarged, begin to injure other tissues, and pinch the nerves. After an injury, the joints begin to wear out faster. Hormonal changes and, oddly enough, everyday habits also affect, for example, during sleep, take a pose with strongly bent arms, while working, constantly rest your elbows on the table, and for drivers – against the edge of the car door.The causes of some diseases are not fully understood.

– What symptoms should lead a person to a doctor?

– You should always consult a specialist if your fingers gradually or suddenly become numb – this is a sign of a pinched nerve, also if a neoplasm has appeared and it begins to grow. When a person does not go to a doctor due to diseases that manifest numbness of the fingers, night pains, the nerve is damaged more and more – the fingers lose sensitivity, the muscles of the hand begin to atrophy, the hands become weak, it becomes difficult to take small objects, the hands are afraid of the cold.In this case, even after the operation, the hand function may not fully recover. If the finger gets stuck and the disease progresses, even after the operation, movement may remain limited.

Very often it is difficult for patients to name clear symptoms, so conditions in which a nerve is pinched can remain undiagnosed for a long time. By contacting on time, the patient can receive qualified assistance. Very informative in these cases is a diagnostic study – electroneuromyography, which helps to establish the degree and amount of damaged tissues.

– What is the tactics of treating the listed diseases?

– At the initial stage, these diseases are treated conservatively. If this does not help, the doctor decides if surgery is required. It is important that the patient presents on time. Operations carried out in a timely manner are simple and very effective. When the disease gets far, the effectiveness of the operations is not so high.

Conservative treatment carpal tunnel and ulnar canal syndromes is reduced to reducing physical activity on the arm, prescribing non-steroidal anti-inflammatory drugs, B vitamins that improve blood flow and nerve nutrition, vasodilating drugs, splints. Electroneuromyography helps diagnose these diseases and determine the treatment tactics.

Most often I start the treatment of the “snapping” finger with hormonal blockade by Kenalog. In the treatment of tenosynovitis , a splint, hormonal blockade is prescribed. A neoplasm – in the case of hernias of the wrist, finger joints, tendons – is punctured. Changes in the wrist joints are treated with splints, anti-inflammatory drugs, physiotherapy, and joint injections.

– When is surgery necessary?

– Always with Dupuytren’s contracture , in other cases – if the methods of conservative treatment do not help, and the symptoms persist or progress.

Operations are compensated by the Health Insurance Fund, so the patient can not wait in line and go to any clinic that can carry out such an operation, for example, to our Center. After all operations, the patient is discharged home the same or the next day.The main thing is not to hesitate at the first symptoms in order to prevent serious diseases.

For all questions, please contact your personal manager
Beate Putramenete by phone: +370 687 99 342 (Russia, Viber, WhatsApp) or by email. by mail: [email protected], as well as by the general number of the department for the reception of foreign patients: +370 5 247 63 69

Knott’s disease (stenosing ligamentitis)

Stenosing ligamentitis (Knott’s disease or “clicking” finger) is a disease of the hand that is characterized by the typical “snapping” of the finger or fingers at maximum flexion into a fist, restriction of movement, pain at the base of the fingers upon pressure, morning stiffness in the hand.Often occurs against the background of systemic diseases – diabetes mellitus, gout, rheumatoid arthritis.

Typical signs of stenosing ligamentitis:

  • Characteristic clicking sensation when extending the finger or fingers
  • pain at the base of the finger on pressure
  • The presence of a dense, rounded mass at the base of the toe
  • feeling of stiffness, difficulty in bending or extending the fingers, mainly in the morning

Allocate 4 degrees of the disease:

1 – pain, periodic snapping

2 – visible snaps of the finger, the finger unbends on its own

3 – visible snaps, you can straighten your finger only with the second hand

4 – it is impossible to straighten the finger even with the second hand


Depending on the degree of the disease, various methods of treatment are used.

At 1-2 degrees, a blockade with hormonal anti-inflammatory drugs is performed, and physiotherapeutic treatment is also prescribed.

With the ineffectiveness of the blockade, as well as with 3-4 degrees of the disease, surgical intervention is recommended – dissection of the A1 ligament at the base of the finger. This operation can be performed in two ways: openly, with a small skin incision, stitches and further dressings, or minimally invasive, through small skin punctures with a needle, without stitches and dressings.

What is needed for treatment in one visit?

Thanks to modern information technologies, solving many problems in one visit is quite possible. To do this, you only need to answer questions and send photographs of hands to [email protected] Our specialists will study the information received and draw up an individual treatment plan.

It is desirable to indicate in the letter:

  1. Full name and year of birth
  2. Contact phone number and city of residence
  3. Do you have tight subcutaneous bands or deep folds in your palm and fingers?
  4. Do you experience snapping or snapping of your finger or fingers when extending?
  5. Are your fingers going numb (do you wake up feeling that your hand is lying down?)
  6. Can you forcefully extend your finger or fingers with your other hand?
  7. Do you have problems with your arm after your injury?
  8. Have you been operated on before? If so, where and when (it is advisable to send a copy of the discharge summary after the operation, and mark the postoperative scar on the photo of the hand with a marker)
  9. Attach a photo of the hand (top view, side view), it is desirable to indicate with a marker or pen problem areas on the hand
  10. Do you have any chronic diseases – rheumatoid arthritis, gout, diabetes mellitus, etc. NS.?

In an arbitrary form, describe the problem (what worries and for how long), to whom you turned for help (what kind of treatment you received and whether it had an effect), what research was carried out (if any, you must attach copies of medical documents).

In addition, you can simply make an appointment by phone 8 (812) 406-88-88 for an operation for Knott’s disease without answering questions and sending photos. If there are no contraindications, you may also be offered treatment in one visit.

Hand Surgery Center

90,000 Knott’s disease – symptoms, causes, treatment

Stenosing ligamentitis, or Knott’s disease is a disease of the flexor tendon of the finger. In the people, pathology is called the clicking finger because of the characteristic sound when the finger is bent. Often, patients believe that the joint itself clicks, but this is not the case.

The main danger of the disease is that in the absence of treatment, the finger can be fixed in a bent state, and it will be impossible to straighten it without the intervention of a doctor. With the advanced stage of Nott’s disease, limitation of mobility appears.

Pathology is being successfully treated, so if you have such a problem, you should not postpone your visit to the doctor.

Knott’s disease: causes

Knott’s disease in children from 1 year old often appears due to developmental peculiarities. The fact is that the flexor tendon of the finger has annular ligaments. They prevent lateral movement of the tendon, especially when moving.

In young children, it sometimes happens that the tendon grows faster than the ligament.As a result, she crushes him. At this point, the tendon becomes denser. When the lump passes through the narrow ligament channel, a clicking sound is produced. Over time, constriction can cause the lump to become larger, preventing the tendon from moving and thus keeping the finger in a flexed position.

The mechanism of development of pathology in adults does not differ, but the root causes of its appearance are completely different. If an adult is diagnosed with Knott’s disease, the causes of may be as follows:

  • regular loads on the fingers, performing monotonous hand movements;
  • rheumatism that lasts a long time without treatment;
  • inflammation localized in the hand;
  • injuries and injuries in the area of ​​thickening;
  • diabetes mellitus;
  • hereditary predisposition;
  • atherosclerosis;
  • thyroid diseases.

In most cases, Knott’s disease causes an inflammatory process, provoked by constant stress. The risk group includes women, as well as people who, by occupation or hobby, constantly perform the same movements (for example, embroider) or have chronic diseases.

How does Knott’s disease manifest?

Stenosing ligmentitis is characterized by slow development, so symptoms initially appear minimal and increase gradually.Most often, pathology is accompanied by the following signs:

  • A clicking sound occurs when a finger is moved;
  • feeling of stiffness, numbness in the affected area;
  • the appearance of pain in the affected area, which increases with pressure;
  • pain in the hand;
  • Decreased physical performance of the affected arm.

Knott’s disease of the thumb manifests itself depending on the stage of its progression:

  1. In the first stage, a click occurs when you move your finger.There may be minimal limitation of mobility.
  2. In the second stage, the impaired mobility of the finger becomes more pronounced.
  3. In the third stage, the finger loses its ability to move. He is usually in a flexed state.
  4. At the fourth stage, irreversible processes occur in the tissues, therefore the pathology is difficult to treat.

When the first symptoms of the disease appear, it is important to immediately go to the doctor. He will diagnose and select an effective treatment depending on the characteristics of the manifestation of symptoms, the stage of neglect and other factors.

Knott’s disease: treatment

If there are suspicions of Knott’s disease, diagnosis
carried out quickly and without complex manipulations. The doctor can make a diagnosis based on the patient’s complaints and the results of the examination. Sometimes radiography is used to confirm it.

Conservative therapy

If early diagnosed Knott’s disease, treatment
can be conservative. An integrated approach is used to eliminate it.The patient is prescribed various procedures:

  • electrophoresis;
  • therapeutic massage;
  • exercise therapy;
  • iontophoresis and other physiotherapeutic procedures;
  • warming up with herbal baths, etc.

From medications, glucocorticosteroids are prescribed, which should be administered to the affected area. They help to eliminate the inflammatory process and the resulting induration.

Conservative treatment takes a long time.In addition, in the presence of provoking factors, there is a high risk of relapse. During the course of therapy, it is important to eliminate the cause of the development of the pathology. If necessary, the patient should change the type of activity or provide the arm with a rest from monotonous movements.

Surgical treatment

If advanced Nott’s disease is diagnosed, operation is the only effective treatment option. Do not be afraid of surgical intervention, since it is minimal, but at the same time it allows you to restore the functionality of the limb.

The essence of the operation is that the doctor makes a small incision in the problem area and opens access to the annular ligament. Then he cuts the ring to allow the tendon to move freely and sutures.

All manipulations are performed under anesthesia, so the patient does not experience pain. After the operation, rehabilitation is indicated to accelerate the healing and restore the functions of the finger. Exercise therapy and remedial gymnastics are prescribed. Due to the minimal intervention, there is practically no risk of complications, especially when contacting an experienced surgeon.

Psoriatic arthritis | Clinical Rheumatology Hospital No. 25

Psoraitic arthritis is a form of chronic inflammatory joint damage that develops in patients with psoriasis.

Clinical signs and symptoms psoriatic arthritis

Arthritis in 68-75% of cases develops in patients with psoriasis, or occurs simultaneously with skin changes; in 12-25% of cases, arthritis precedes the appearance of signs of dermatosis.From the onset of skin lesions to the development of arthritis, as well as from the onset of arthritis to dermatosis, a different period passes – from 2 weeks to 10 years or more. Dermatosis can be widespread, but often limited, localized on the scalp, extensor surfaces of the elbows, knee joints, around the navel, under the mammary glands, in the gluteal and inguinal folds. In some cases, it begins with damage to the nails. Point depressions appear on the surface of the nails (a symptom of a “thimble”), the nail plates become cloudy, longitudinal or transverse grooves are visible on them, sometimes the nails thin and atrophy (onycholysis), but more often they thicken and crumble, as with a fungal infection, which requires the exclusion of mycosis.

The onset of arthritis is most often imperceptible, gradual, but it can also be “acute”.

Five types of joint damage in PA can be distinguished, which are not mutually exclusive and can be combined:

  • arthritis affecting the distal interphalangeal joints;
  • mono-oligoarthritis;
  • polyarthritis similar to rheumatoid;
  • mutating arthritis;
  • spondyloarthritis.

The classic type is inflammation of the distal interphalangeal joints of the hands and feet, the lesion is usually multiple, but asymmetric mono-oligoarthritis may develop at the onset of the disease. In particular, cases of isolated arthritis of the distal joints of the big toes have been described. Palpation of joints in PA is moderately painful, the swelling is usually dense, usually extending beyond the joint. The skin over the affected joints is bluish or purplish. The change in the shape of the end joints simultaneously with the peculiar coloration of the skin creates a picture of “radish” defiguration of the finger. Arthritis of the distal interphalangeal joints, as a rule, is combined with trophic changes in the nails.

An “axial” lesion is also considered characteristic of PA – a simultaneous lesion of the distal, proximal interphalangeal and metacarpophalangeal joints of the same finger up to the development of ankylosis of these joints. Similar changes in the joints of the toes cause their diffuse swelling and redness of the skin – “sausage fingers”. In 5% of patients, a disfiguring (mutating) form of PA is observed, when, as a result of the osteolytic process, the fingers are shortened, bent, multiple subluxations and ankylosis of the joints are found. Asymmetry and disorder (chaos) of these changes are characteristic: on the same hand, for example, flexion and extension contractures of the fingers, displacement of their axes in different directions can be found.

The variants of classic psoriatic arthritis described above are found only in 5-10% of patients with psoriasis. In 70% of patients, mono or oligoarthritis of large joints – knee, ankle, very rarely hip is revealed. More than three joints are affected in 15% of patients.In this case, any articulation can be affected, including the temporomandibular joints. Usually, the asymmetric nature of polyarthritis is quite clearly expressed, although there may be processes that are extremely reminiscent of the clinical picture of RA. In 5% of patients, a clinical and X-ray picture of ankylosing spondylitis develops, as in ankylosing spondylitis, although asymptomatic sacroiliitis is radiologically detected in 50-60% of patients. PA can be combined with eye damage (more often conjunctivitis, iritis, less often episcleritis). The simultaneous occurrence of ulcerative lesions of the oral mucosa and genitals brings the clinical picture of the disease closer to Reiter’s disease.

Lesions of internal organs become distinct with a particularly severe (malignant) variant of PA. It develops only in males, mainly young people (up to 35 years old) and, as a rule, suffering from atypical psoriasis (pustular psoriasis or universal psoriatic erythroderma). This variant is characterized by high fever of the hectic type with chills and increased sweating.The articular syndrome is manifested by multiple arthritis with a pronounced exudative component of inflammation, excruciating pain, sometimes even requiring the administration of drugs. At the same time, progressive weight loss, the formation of trophic ulcers, pressure ulcers, increased hair loss, amyotrophy, generalized enlargement of the lymph nodes, especially the inguinal ones, are detected. Of the internal organs, the heart is most often affected by the type of myocarditis, manifested by a moderate expansion of the boundaries of the heart, a weakening of the first tone, systolic murmur, tachycardia that does not correspond to fever, rhythm disturbances and diffuse changes in the myocardium according to ECG data. Development of hepatitis, hepatolienal syndrome is possible. At the height of the disease, there are sometimes signs of diffuse glomerulonephritis, and with prolonged course – renal amyloidosis. In the malignant variant of PA, encephalopathy can be observed with a predominant involvement of subcortical formations in the process, epileptic seizures and delirium. Sometimes peripheral neuritis and polyneuritis develop.

Laboratory data are not specific. In the general analysis of blood, the acceleration of ESR is determined, which correlates with the activity of arthritis.

X-ray changes are the most significant in differential diagnosis.

How is psoriatic arthritis treated?

Treatment of psoriatic arthritis has similar principles to the treatment of rheumatoid arthritis.

1. Non-steroidal anti-inflammatory drugs (NSAIDs).

Monotherapy of NSAIDs is indicated only with relatively favorable variants of PA (oligoarthritis, damage to the distal interphalangeal joints). With the ineffectiveness of NSAIDs, the appointment of basic anti-inflammatory drugs is indicated. In some cases, NSAIDs lead to an exacerbation of cutaneous psoriasis.

2. Glucocorticoids (GC).

Prescribing HA in low doses (10-15 mg / day) is rarely used. Potential indications are generalized peripheral arthritis with severe functional insufficiency of the joints, high activity of the inflammatory process, ineffectiveness of NSAIDs, the presence of systemic manifestations (aortitis, diffuse glomerulonephritis, malignant form).Local therapy of HA is indicated for limited joint damage and enthesopathy (damage to the ligamentous apparatus).

3. Basic anti-inflammatory drugs (DMARDs).

a) Methotrexate – indicated for a high degree of disease activity in combination with a progressive stage of generalized psoriasis and for atypical dermatosis (pustular and erythrodermic).

b) Cyclosporine – has no advantages over methotrexate in its therapeutic potential, but causes more severe side reactions (nephrotoxicity, the development of arterial hypertension).

c) Sulfasalazine – has a moderate effect on joint and skin lesions, but does not affect the clinical manifestations of spinal lesions and the progression of arthritis.

g) Leflunomide (Arava) is a promising drug, the effectiveness of which has been proven in randomized clinical trials.

4. Genetically engineered biological preparations (GIBP)

Currently, more and more new biological drugs are being developed that have a more pronounced therapeutic potential, but at the same time can cause severe adverse reactions, which requires special control before prescribing these drugs.

The most common treatment for psoriatic arthritis in Russia in the last decade has been infliximab (remicade), which is effective in the most severe patients who are resistant to standard therapy.

One of the auxiliary methods of psoriasis treatment is HIRUDOTHERAPY – treatment with leeches, especially if physiotherapy is contraindicated for the patient.

More details about the work of a rheumatologist and the procedure for applying can be found on the pages “Patients” and “Procedure”.


90,000 Why do joints hurt and what you need to do


Why joints hurt and what should be done at the same time

Joint pain and swelling are common in many different conditions. The earlier the diagnosis is made and the correct treatment is started, the greater the success of the therapy.

Arthritis is considered “early” if the diagnosis is made within 6 months of the first symptoms of the disease.There are early arthritis clinics in a number of European countries.

Symptoms of arthritis are: joint pain, joint swelling, stiffness of movement, local increase in soft tissue temperature around the joint. Common symptoms such as weakness, fever, weight loss are possible. For a timely diagnosis and the appointment of the correct treatment, the patient should consult a specialist doctor – a rheumatologist.

Unfortunately, due to the widespread advertising of non-traditional methods of treatment, patients often turn to chiropractors, osteopaths, homeopaths – and time is lost.In particular, in the treatment of rheumatoid arthritis, the first 3-6 months of the disease are called the “window of opportunity” – this is the time when correct treatment can lead to persistent and long-term remission.

Now let’s talk about the symptoms of the most common rheumatological diseases.


Osteoarthritis is the most common joint disease that usually occurs in people over 40-45 years old.Women suffer from osteoarthritis almost 2 times more often than men.

The most clinically significant and disabling forms of osteoarthritis are coxarthrosis (arthrosis of the hip joint) and gonarthrosis (arthrosis of the knee joint). With nodular osteoarthritis, there is a lesion of the interphalangeal joints of the hands (pain and deformity).

The main clinical symptom in osteoarthritis is pain in the affected joint during exertion. With arntrosis of the knee or hip joint, the patient experiences pain when walking, when getting up from a chair, when walking on stairs (especially when descending), when carrying weights.In addition to pain, the patient is worried about limitation of movement in the joint, crunching during movement.

Sometimes there is a swelling (effusion) of the knee joint (it can be swollen behind, under the knee). This is a symptom of joint inflammation.

In the case of effusion (synovitis), the nature of the pain changes: pain appears at rest, not associated with exertion.

Rheumatoid arthritis

Rheumatoid arthritis usually affects middle-aged women.The most characteristic symptoms are symmetrical (on the right and left extremities) arthritis (pain, swelling) of the wrist joints, small joints of the hands and feet. Joint pains are more troubling in the morning. It is difficult for the patient in the morning to clench his hand into a fist, raise his hand (comb his hair), step on his feet (due to pain under the “pads” of the toes). Joint pains are accompanied by a characteristic symptom – “morning stiffness”.

Patients describe morning stiffness as a feeling of “swelling, stiffness in the joints”, “hands with tight gloves.”In addition to articular syndrome, rheumatoid arthritis is characterized by such general symptoms as weakness, weight loss, weight loss, sleep disturbance, and fever.

You need to know that rheumatoid arthritis is a chronic disease. Rheumatoid arthritis can be disabling if diagnosed late and improperly treated. Often the disease begins gradually, often with arthritis of one joint, then other joints “join”.

In order to use the “window of opportunity” and promptly start treatment for persistent arthritis (2-3 weeks), especially for arthritis of small joints, it is necessary to consult a rheumatologist. To confirm the diagnosis, immunological tests, radiography, and MRI are used.


This is a group of diseases that include ankylosing spondylitis (ankylosing spondylitis), psoriatic arthritis, spondyloarthritis associated with inflammatory bowel diseases, reactive arthritis (associated with urogenital or intestinal infection), undifferentiated spondyloarthritis.

This group of diseases is united by common genes and common clinical symptoms.Spondyloarthritis usually occurs in young people (up to 40 years old). Spondylitis is an inflammation of the joints of the spine. Often, the first symptoms of spondylitis are pain in the lumbosacral region, alternating pain in the buttocks (sometimes on one side or the other). These pains are inflammatory in nature: they increase in the second half of the night or in the morning, decrease after a warm-up, do not go away at rest, are accompanied by morning stiffness in the spine. Spondyloarthritis often affects the hip joints (the first symptom is often groin pain).

Spondyloarthritis is characterized by the presence of asymmetric arthritis, mainly in the joints of the lower extremities. Unfortunately, the correct diagnosis is often made 8-10 years after the onset of the disease, especially when the patient has pain in the spine, but no arthritis.

These patients are continuously followed up by neurologists and chiropractors with a diagnosis of osteochondrosis. For a correct diagnosis, an additional examination is necessary: ​​MRI of the sacroiliac joints, X-ray of the pelvis, blood test for the presence of a specific gene.


Men get gout about 20 times more often than women. Gout develops mainly during the fifth decade of life.

The “classic” symptom of gout is paroxysmal arthritis, usually of the I (big) toe. Arthritis occurs acutely, more often at night or early in the morning, after a heavy meal, drinking alcohol, as well as after a minor injury, physical exertion.

Gouty arthritis is accompanied by severe pain (the patient cannot step on his foot, does not sleep at night because of the pain, the pain intensifies even when the joint is touched with a blanket).In addition to severe pain, there is a pronounced swelling of the joint, redness of the skin over the joint, movements in the inflamed joint are almost impossible. Arthritis can be accompanied by a high fever. A gout attack disappears after a few days (at the onset of the disease – even without treatment).

In most patients, the second “attack” of gout is observed in 6-12 months. In the future, there is a gradual increase in the frequency of “attacks” of arthritis, there is a tendency for their more protracted nature.All new joints are involved: knee, ankle, elbow. Without treatment, the patient develops chronic gout: chronic arthritis, kidney damage, subcutaneous formation of tofuses (nodules with a significant accumulation of uric acid crystals).

Gout is associated with metabolic disorders, increased levels of uric acid. In most patients, the cause of the disease is impaired renal excretion of uric acid. Patients with gout, as a rule, have other metabolic disorders: overweight, increased blood pressure, increased cholesterol levels, urolithiasis, ischemic heart disease.This requires a comprehensive examination and treatment.

Polymyalgia rheumatica

Older persons (after 50 years of age) get sick. At the peak of the disease, pain and limitation of movement are characteristic in three anatomical regions: in the shoulder girdle, pelvic girdle and neck. It can be difficult for the patient to determine what is hurting: joints, muscles or ligaments.

In polymyalgia rheumatica, the general condition of the patient suffers, often there are symptoms such as fever, weight loss, loss of appetite, poor sleep, depression.There is a marked increase in ESR.

Patients usually undergo a thorough cancer screening. If the patient does not consult a rheumatologist, then the appointment of the correct treatment is “postponed” for a long time. It should be noted that joint pain and arthritis are also a symptom of more rare diseases of the rheumatological profile – diffuse connective tissue diseases (systemic lupus erythematosus, systemic scleroderma, dermatomyositis, Sjogren’s disease, Behcet’s disease, systemic vasculitis).

There is a whole group of diseases of extra-articular soft tissues, the so-called “periarthritis” (tendinitis, tendovaginitis, bursitis, enthesopathy).

Changes in soft tissues can be one of the manifestations of systemic diseases, but much more often they occur due to local overloads, microtraumas, overvoltage. Inflammatory changes in soft tissues, as a rule, respond well to periarticular (periarticular) drug administration. Inflammation in the joints can occur after injuries and require surgical intervention.These problems are dealt with by orthopedists.

Osteoporosis can be a complication of chronic joint diseases. Densitometry is required to accurately diagnose osteoporosis.

Treatment of osteoporosis associated with joint diseases is also carried out by a rheumatologist. Finally, arthritis can be a symptom of other non-rheumatologic diseases.

Arthritis occurs in tuberculosis, sarcoidosis, malignant neoplasms, amyloidosis, endocrine diseases, diseases of the blood system and other pathologies.

In conclusion, I would like to note once again that the diagnosis of joint diseases is carried out by a specialist rheumatologist. Treatment of articular pathology should be comprehensive and differentiated. With the correct, timely diagnosis, treatment will be more successful.

In the Multidisciplinary Professorial Medical Center “Vascular Clinic on Patriarch’s” you can get advice from a highly qualified rheumatologist with extensive experience in the leading scientific rheumatological organization of the USSR and Russia, Candidate of Medical Sciences Elena Efimovna Gubar.We can also carry out all types of laboratory tests, including immunological, biochemical, general, and genetic tests.

In our own pharmacy, we sell all the drugs necessary for the treatment of joint diseases.

We will be glad to see you from the clinic.

Butterfly Children Foundation – Bandaging fingers and toes

Bandaging the fingers with bandages: instruction for parents

Bandaging the fingers and toes of a butterfly baby is difficult.If the bandage is not properly secured, it will move, come into contact with the wound or bladder, and cause pain to the baby.

Let’s talk about the main methods of dressing. Please note: before bandaging, the child’s fingers should be lubricated with petroleum jelly, bepanten or Akvofor ointment.

Bandaging of fingers with bandage

This manual was developed by Lorraine Spaulding, the mother of a seven-year-old boy with recessive dystrophic epidermolysis bullosa.

1. From Vaseline gauze or soaked in petroleum jelly, make a bandage 17 cm long and 8 cm wide. Step 2.5 cm from the edge of the band and make a 10 cm deep incision towards the center.

2. Wrap it around your arm so that the 2.5 cm strip is between your thumb and forefinger. This will provide additional protection if your hand is already wounded and will help keep your palm moist and soft.

3.Using a bandage 2.5 cm wide, start at the wrist. Wrap around the hand, then go up to the thumb as shown. Wrap your thumb and go back down.

4. Down the thumb, wrap around the inside of the palm, pass over the outside of the hand, then stretch up to the index finger, wrap it – first up, then down, and pass over the inside of the palm.

five.Continue doing the same with your middle finger. Always start wrapping the tip of your finger on the outside of the hand, where the nail plate is.

6. At this point, the bandaged arm should look something like this. Continue in the direction of the arrow.

7. Stretch the bandage down, run along the inside of the palm and move to the ring finger. First wind your ring finger up and down from the pad.

eight.From your ring finger, pull the bandage down and wrap it around your wrist. Then pull the bandage along the outside of the hand to the gap between the thumb and forefinger, and inside the palm towards the little finger. Wrap your pinky up and down, just as you did with your other fingers.

9. After bandaging the little finger, return the bandage to the wrist.

10. The tips of the fingers can be left slightly open for the child’s sense of touch to work.

11. At this stage, the inner side of the palm is not yet completely closed, leaving no bandaged places. Close all gaps. Be very careful! Never pull gauze or bandage too tight!

12. From your wrist, stretch the bandage along the inside of your hand to the space between your little finger and ring finger. Go back to the outside.

13. Cover the bottom of the inner palm with a bandage and slide the bandage along the outer side of the hand to the space between the middle and forefinger.

14. On the inside, slide the bandage to the bottom of the edge of the palm and on the outside of the hand, move up to the space between the thumb and forefinger.

15. On the inside of your hand, slide the bandage to the base of your little finger, and then, on the outside, slide it to the space between your middle and ring fingers. After passing the bandage between them, return to the wrist on the inside.

sixteen.At this point, the inside of your hand will look something like this.

17. Take a second roll of cheesecloth, 5 cm wide. Wrap over the first roll on the inside of the base of the ring and little fingers. Wrapping the bottom of the outside of the hand, work your way up the inside to the space between your thumb and forefinger.

18. Make a full “turn” so as to secure the folded “start” (3-4 cm) of the second roll.Do not pull the bandage too tight. Make sure the palm stays straight and does not bend. The second layer will provide additional protection.

19. Wrap the changeover site one or two more “turns” and then move to the wrist to finally secure the bandage.

20. When you have bandaged the brush, put on a supporting mesh stocking over it. For the thumb, cut a hole in it.

Bandaging fingers without bandaging

    You can do without bandaging, using tubular bandages that are simply put on the fingers.

    1. Take the Paul Hartmann seamless knitted tubular bandage Stülpa with a high degree of stretch and an elastic tubular bandage for fixing the bandages on the fingers – for example, no. 1 from 36.6.
    2. Cut the bandages so they are slightly longer than your fingers.
    3. Treat blisters and wounds on fingers as usual. For this, use a contact wound dressing “Mepitel” or “Urgotul”, an antiseptic “Octenisept” or any other, needles for piercing blisters.
    4. Apply the cream or ointment you usually use to your child’s fingers – Sudocrem, Bepanten Plus or others.
    5. On each finger over the cream, put on a “shtulpa” and fasten on top with a tubular bandage for fixation. Try to choose the length of the bandages so that you don’t create unnecessary folds between your toes.

    Bandaging fingers to preserve joints

    The instructions for bandaging fingers in this way were provided by the Austrian house of epidermolysis bullosa EB-haus and the Debra Austria association (Salzburg, Austria).

    The special direction of applying the bandage allows you to correct the wrong position of the fingers.

    Remember that you shouldn’t overtighten your fingers! With this method, it is ideal to use self-fixing elastic bandages: this way, the fingers bandaged with them can bend slightly at the joints.

    So, here are the instructions.

    1. Using a bandage 3-3.5 cm wide, start bandaging from the wrist. Wrap the bandage around the wrist 2-3 times.

    2. Go upstairs to the thumb.

    3. Wrap your thumb, starting from the outside of the hand, as shown in the illustration.

    4. On the outside of the hand, return to the wrist from the edge of the palm.

    5. Having wrapped the wrist once, on the outside of the hand, pass the bandage between the middle and forefinger.

    6. Wrap your index finger in the same way as you did with your thumb, and again return to the wrist.

    7. After making another turn around the hand, wrap the middle finger in the same way.

    8. Return to the wrist again.

    9. Repeat this step for your ring finger.

    10. Return to your wrist.

    11. Wrap the little finger from the edge of the palm, passing the bandage lastly between the little finger and ring finger. Return the bandage to your wrist from the thumb side.

    12. Attach the end of the bandage to your wrist. From the side of the palm, the bandaged arm should appear as shown in the illustration.

    Bandaging toes

    The procedure will be as follows:

    1. Treat wounds as usual.Use scissors to cut rectangular strips of Paul Hartmann’s Rolta Soft bandage. Run them around the affected toes, applying ointments and creams underneath. Place them around the affected toes, applying ointments and creams underneath.
    2. Wrap over with the same bandage, being careful to avoid folds and excessive layers of layers, especially at the joints.
    3. Secure with the Peha-Haft self-fixing bandage.
    4. For additional fixation of the bandage, put a cotton sock on the foot with the seams outward.It is advisable to cut off the elastic.

    Gloves for hands

    You put the cream on the child’s hands, and after 5 minutes it is on the upholstery of the sofa. A familiar picture, isn’t it? But the problem is solved simply: after applying the cream, the child needs to put on gloves.

    For butterfly babies, soft gloves are an effective protection for fingers from growing together and moisturize the dried skin of the hands. Always wear gloves, day and night, so that you do not have to undergo painful finger separation surgery in the future.

    Even if you do not bandage the whole hand, but one or more fingers, still wear gloves. Then the kid will thank you!

    How to make a glove?

    1. Place your baby’s hand on a sheet of thick paper or thin cardboard and carefully trace the entire brush with a felt-tip pen, paying particular attention to the contour of the fingers. This procedure is good for both the left and right hands of the baby – even if at first glance they seem to be the same.

    2. On the resulting contour, step back 1 cm from the fingertips and mark the cutting line. This will create gloves with open fingertips. We measure 5 cm from the conditional line of the wrist so that the gloves are not too short.

    3. For gloves, choose a soft knit fabric, 100% cotton or a touch of Lycra. Attach the pattern cut out of cardboard to the fabric and trace its outline with a felt-tip pen or crayon.Step back 1/2-inch on the seams on the outside of the little finger and thumb and mark on the pattern. Do not allow seam allowances on the other sides of the toes.

    4. Cut four identical pieces, provided that the jersey is double-sided and the baby’s palms are equally developed. If there is a face and a wrong side, then you need to cut out 2 parts for the right hand, and 2 for the left (in a mutually mirror image).

    5. Sew the two pieces together along the outer sides with an allowance so that the seams are facing out.

    6. Cut a strip 2 cm wide and 25-30 cm long for inserts between the toes.

    7. Sew this insert between thumb and forefinger first, cut off the remaining fabric. Next – between the rest of the fingers.

    8. The glove is ready, it remains to make the second in the same way. Be sure to try it on and make sure that the child is comfortable. Excellent protection for your child’s fingers – done! Now he can play calmly without fear of injury.

    90,000 Gout (gouty arthritis) | Medical center Your Health

    Gout (gouty arthritis) is an metabolic pathology of the body, in which the metabolism of purines (uric acid derivatives) is affected, which leads to excessive deposition of uric acid salts in some tissues of the body.

    It is as a result of these deposits that dysfunctions of organs and tissues are formed.The joints, kidneys and some other organs (bones, ligaments, liver) are especially affected.

    Gout has been known for a long time, proceeds with periods of remission and gouty attacks, more often affects middle-aged men, women suffer no more than 1-2% of all cases of gout.


    The basis of gout is a genetically inherited defect in the metabolic processes of uric acid, a defect in enzymes that help its utilization and excretion, as well as defects in the system of internal synthesis of purine substances.

    In addition to genetic reasons, risk factors and external influences that predispose to the development of gout are no less important for the development of gout:

    • Increased intake of purine bases from food with abuse of meat products,
    • obesity and overweight,
    • alcoholism, excessive drinking,
    • bad habits, inactivity.

    Development of secondary gout is possible

    • against the background of tumor processes with changes in purine metabolism,
    • against the background of increased breakdown of body proteins,
    • in the treatment of thiazide diuretics (dichlothiazide, polythiazide),
    • when using cytostatics (doxorubicin, fluorouracil, hydroxyurea, cyclophosphamide).

    Gout attacks can be triggered by stress reactions to alcohol, citrus fruits, viral infections, physical or mental stress, trauma and hypothermia, bruises, pressure fluctuations, and medication.


    Most often, with gout, the kidneys and joints are affected, therefore,

    can be distinguished

    • gouty arthritis
    • gouty kidney disease.

    There are also three types of gouty disorders, based on the level of uric acid in the urine:

    • metabolic form with the highest amount of uric acid.
    • renal form, moderate amount of uric acid with increased salts,
    • mixed form – a lot of uric acid and its salts, which give crystals.

    Symptoms of gout

    Gout is a chronic and progressive disease, it can occur in three successive stages –

    • acute arthritis of gouty origin,
    • stage of interictal gout,
    • Tofus chronic stage of gout.

    Gouty arthritis occurs suddenly: at night or in the morning, there are burning, throbbing or tearing pains of one or more joints, usually on the legs and their lesion is asymmetrical.

    Quite often, the joint of the big toe is affected first.

    The lesion usually affects the foot or ankle, knees, finger joints, elbows. There may be swelling of the veins around the joint, fever, and chills.

    Due to severe pain and swelling, movement of the joint is almost impossible.During the day, the pain subsides somewhat, and by night it reappears, which leads to neurosis and irritability.

    After 3-4 days the pain subsides, the joint acquires a cyanotic hue, the edema gradually subsides.

    During seizures, blood tests change – inflammation is detected in the blood with an accelerated ESR, high leukocytes and an increase in the proteins of the acute phase of inflammation.

    Seizures can occur in different periods – from once every six months to several years. As gout progresses, the frequency of attacks increases, they become longer and less acute, but more and more joints are involved in the process.

    Chronic gout

    Chronic gout forms areas of tofuses – these are nodular accumulations of salts in tissues approximately 5-7 years after the onset of the disease.

    Topuses appear inside the auricles, in the area of ​​the joints of the hands and feet, elbows, knees, their sizes can be from a couple of millimeters to a pea or more. As the progression progresses, the joints change, there are deformities, curvatures, limited mobility and pain during movement.

    In addition to the joints, the kidneys are affected. The changes are stronger, the higher the level of uric acid and urate in the urine, and the longer the illness.

    There is a so-called urate nephropathy with inflammation of kidney tissue, excretion of salts, deposition of sand and stones and the formation of urolithiasis.

    There are periods of renal colic with back pain, nausea and vomiting, and secondary pyelonephritis, with fever, leukocytes in the urine, symptoms of dysuria and general serious condition may develop.

    Urates can be deposited not only in the renal pelvis, but also in the kidney tissue, its cortex and medulla, this leads to a gradual atrophy of kidney function and the development of renal failure.

    There may be lesions of the tendons with the deposition of salts in them, while developing redness and swelling in the tendon area, severe pain and problematic movements.

    The risk of developing coronary heart disease is also higher; some patients develop severe obesity.


    The basis of the diagnosis is typical gout attacks with joint damage.Complementing the data of blood tests with signs of acute inflammation, urine tests with high levels of urates and uric acid, creatinine, in the punctate from the joint, the detection of urate salts.

    In acute gout

    For primary diagnosis, a study of the articular fluid is required. With attacks of gout, it is transparent, its viscosity is reduced, leukocytes in it are up to 75%, crystals of uric acid are found.

    With prolonged gout

    It is obligatory to conduct an X-ray with the detection of certain signs in the clinic:

    • maximum inflammation on the first day,
    • multiple attacks of arthritis,
    • lesion of one joint,
    • joint redness,
    • inflammation in the first joint of the big toe,
    • Tofus suspected,
    • increase in the level of urate in blood and urine,
    • Typical signs of joint damage on x-rays.


    The same symptoms can be signs of different diseases, and the disease may not proceed according to the textbook. Do not try to heal yourself – consult your doctor.

    Rest and cool wraps are very important in the treatment of acute gouty arthritis.

    An important place is occupied by colchicine, prescribed 0.5 mg every hour until arthritis subsides, or until the appearance of side effects (vomiting, diarrhea), but not less than 6-8 mg / day.

    Colchicine is used for the treatment of an acute attack of gout for no more than a day.

    Indomethacin, ibuprofen, naproxen, piroxicam are usually used in large doses and in a short course (2-3 days). Special care should be taken in case of concomitant liver and kidney diseases, especially in elderly patients.

    Treatment with anti-gout drugs is carried out with primary gout for life, with secondary – depending on the elimination of the situation that provokes the development of gout.

    With a reduced excretion of urates, preserved renal function and the absence of urinary stones, it is possible to use allopurinol + benzbromarone, used 1 tablet 1 r. / Day, probenecid.

    The generally recognized uricostatic (i.e., blocking the production of urate) drug is considered allopurinol.

    Allopurinol is prescribed at a starting dose of 100 mg / day. followed by a gradual increase in the dose to 300 mg / day. in 3-4 weeks.

    With increased excretion of uric acid in the urine and / or gouty kidney damage, preference is given to allopurinol.

    Diet for gout

    Foods to be excluded:

    • alcoholic beverages (especially beer),
    • internal organs of animals (liver, kidneys).

    Foodstuffs whose consumption should be limited:

    • fish (caviar, Baltic herring, sardines, etc.; larger fish is acceptable in the diet),
    • crustaceans,
    • meat (veal, pork, poultry, broths),
    • some vegetables (peas, beans, mushrooms, cauliflower, asparagus, spinach).

    Foods that can be consumed without restrictions:

    • cereals (bread, cereals, bran),
    • dairy products (milk, sour cream, cheese),
    • all fruits and fruit juices,
    • fats (butter, margarine, cooking oil),
    • coffee, tea,
    • chocolate,
    • most vegetables (potatoes, lettuce, cabbage, tomatoes, cucumbers, pumpkin, onions, carrots, beets, radishes, celery),
    • sugar (but: causes weight gain!),
    • spices.


    Gout is a chronic progressive disease that cannot be completely cured, but the disease can be brought into a state of long-term remission.

    Seizures usually heal in 2-4 weeks, but can occur every six months or more often, so taking drugs that lower the level of uric acid and its salts can even be lifelong.

    Source: diagnos.ru


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