Enthesitis and Psoriatic Arthritis

[Morganalefaye]

I’m interested to hear from anyone who suffers from enthesitis with PsA?

Does this condition cause the joints to swell?

Does it raise the ESR/CCP markers for inflammation?

[thekeys46]

Hi, I apparently have PsA

The rheumatologist told me I could be flaring without raised ESR and CRP. I have a enthesitis. Although some joints are painful I only seem to get mild soft tissue swelling.

Xx

[Morganalefaye in reply to thekeys46]

I’ve had all kinds of autoimmune problems for many years. I’ve finally been diagnosed with PsA, but I don’t seem to have many of the traditional and expected symptoms. I’ve suspected for a long time, although I wasn’t able to describe it adequately until I heard of enthesitis, that I had a problem with tendons. I had both hips replaced. Although the left hip wasn’t so severe in terms of osteoarthritis on the left side, I asked them to replace the left first because it was actually more painful. I’ve had nothing but trouble with that hip. It’s never healed properly, and was unimaginably painful the first days after the op. Had very little trouble with the later, right hip replacement. I now suspect that I had enthesitis in that left hip. Maybe still do? My ESR and CPR results tend to go up and down, often within normal range, but I put that down to non steroidal anti-inflammatories, and Salazopyrin. Do you know if Methotrexate have any effect on enthesitis?

[thekeys46 in reply to Morganalefaye]

Prior to December 2018 I was on Humira, salazopyrin and cellcept. This seemed to control things. I then had breast cancer and was on herceptin for a year so had to come off all other meds for PsA. Once my year of herceptin finished I started flaring. November 2020 I had a minor heart attack and stent inserted. I am now now only on Humira and seem to be in a constant flare. Quality of life is zilch. I’ve developed peripheral artery disease and have probable micro vascular angina. I last saw a rheumatologist 18 months ago and there was talk then of going on to methotrexate too. I feel I need the addition of another DMARD. Told by appointments office that I’ll be seen when I get to the top of the list🙁

[Morganalefaye in reply to thekeys46]

You’ve been through the mill. I can empathise with your quality of life being zilch. I’m in so much pain with my various forms of arthritis and flaring Crohn’s I seem to spend half my time in bed in pain, so mine’s pretty poor too. I (finally) saw a rheumatologist last August, who recommended Methotrexate on 31/8/22, and I’m still waiting because letters between the rheumatologist, my gastroenterologist and my GP seem to keep going missing. In the end I wrote to the Rheumatologists specialist nurse myself last week, but still no answer. Perhaps they’re on strike?

[Batty1]

I have been dealing with PSA (Enthesitis) for 7 years now …. What a nightmare disease and yes it can cause swollen joints because every joint has a tendon and when your tendon is attacked it makes your joint swell especially in the knees.

Elevated ESR and CRP is classic PSA flare… I finally started to see my marker drop and boom they skyrocketed again … annoying and life sucking.