noticed this pattern enough times now that i started actually logging it instead of just feeling it. every flare, without exception, starts in my second and third PIP joints on the right hand. not the wrists, not the knees. those knuckles.
last one: monday morning both knuckles swollen, hard to make a fist. tuesday nothing new. wednesday my wrists joined in, could barely turn a doorknob. by friday both knees were stiff getting out of bed.
so roughly 4 days from first knuckle to full-body involvement. i went back through my log and 5 of my last 6 flares followed that same order, small joints first then it spreads outward within a week. my rheumatologist says this tracks with how RA typically presents but she’d never actually seen the day-by-day sequence until i brought her the printout. labs that week were unremarkable, CRP barely moved, but the joint progression told the real story.
exporting the whole log as a pdf before that appt ended up being the thing that got her to actually look at the pattern instead of just the labs. what gets me is the knuckles never seem to fully calm down b/w flares. everything else resolves. those two joints stay a little puffy, a little stiff, like they’re keeping the door cracked open for the next one.
anyone else have a joint that always goes first? curious if it’s usually the same hand, same finger, or if it moves around for people. trying to figure out if this is useful information or just something my body does for no reason.