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Over time, this imbalance in the joint can lead to damage to the articular surface. Since articular cartilage cannot heal itself very well, the damage adds up. Eventually, the joint can no longer compensate for the increasing damage, and symptoms begin. The damage in the joint starts well before the symptoms of arthritis appear.

Pain is the main problem with arthritis. At first, the pain usually only causes problems when you begin an activity. Once the activity gets underway, the pain eases. But after resting for several minutes the pain and stiffness increase. When the arthritis condition worsens, pain may be felt even at rest. The sensitive joint may feel enlarged and warm to the touch from inflammation.

In rheumatoid arthritis , the fingers often become deformed as the disease progresses. The MCP joints of the fingers may actually begin to point sideways (towards the little finger). This is called ulnar drift . Ulnar drift can cause weakness and pain, making it difficult to use your hand for daily activities.

Both rheumatoid arthritis and osteoarthritis can affect the IP joints of the fingers. The IP joints may begin to flex (bend) or hyperextend (over straighten), causing characteristic finger deformities. Swan neck deformity occurs when the middle finger joint (the PIP joint) becomes loose and hyperextended, while the DIP joint becomes flexed. When the PIP joint flexes and the DIP joint extends, a boutonniere deformity forms.

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Both forms of arthritis can cause enlarged areas over the back of the PIP joints. These areas tend to be sore and swollen. They are known as Bouchard's nodes . Osteoarthritis causes similar enlargements over the DIP joints, called Heberden's nodes .

How do doctors identify arthritis?

The diagnosis of arthritis of the finger joints begins with a history of the problem. Details about any injuries that may have occurred to the hand are important and may suggest other reasons why the condition exists.

Following the history, a physical examination of the hand and possibly other joints in the body will be done. Your doctor will need to see how the motion of each joint has been affected.

X-rays will be taken to see how much the joint has changed. These tests can help determine how bad the degenerative damage from the arthritis has become. The X-rays also help the doctor estimate how much articular cartilage is still on the surface of the joints.

What can be done for the condition?

Treatment usually begins when the joint first becomes painful. This may only occur with heavy use and may simply require mild anti-inflammatory medications, such as aspirin or ibuprofen. Reducing the activity, or changing from occupations that require heavy repetitive hand and finger motions, may be necessary to help control the symptoms.

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Several thousand people rallied outside the local government headquarters

The shops and cinema auditoriums were packed with families enjoying the school holidays when the fire took hold.

Among them were Igor Vostrikov's; his wife, sister and three children, aged two, five and seven were there.

They suffocated inside a cinema, unable to escape because the doors were locked, he says.

At least 64 people, including 41 children, died when the Winter Cherry leisure centre in the Siberian city of Kemerovo went up in flames on Sunday.

Speaking at a protest in the city centre on Tuesday, Mr Vostrikov told how his wife phoned him , short of breath, as smoke filled the room.

"There was no panic - she was saying goodbye."

"I have nothing more to lose," he said. "All my family died... There's nothing left for me to live now".

Time after time, relatives have described how their loved ones used mobile phones to plead for help or say farewell.

"I cannot escape," 12-year-old Vika Pochankina, who was in the cinema with her classmates, told her aunt Evgeniya Oganisyan on the phone, Russian newspaper Komsomolskaya Pravda reports.

"Tell mum that I loved her. Tell everybody that I loved them," she said. It is unclear if the girl survived.

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"My daughter kept calling me," Mr Lillevyali said.

"I only shouted to her that she should try to get out of the hall, but I couldn't do anything. There was only fire in front of me."

Sergei Moskalenko, 11, survived the inferno after his father pushed the boy from the window, writes the Komsomolskaya Pravda.

Eyewitnesses filmed a horrific video of the boy falling on the asphalt.

He was taken to hospital with serious injuries - but has now regained consciousness.

The boy's parents and four-year-old sister died.

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