about enthesitis

[reef]

has anyone been diagnosed with enthesitis? it appears to be a preliminary condition involved in RA & PsA.

[allanah]

Yes very painful inflammation where the tendons / ligaments attach to the bone. I got steroids and anti inflammatories and doc said it would improve with my RA drugs. Hope you feel better soon, xxA

[reef in reply to allanah]

thanks. i hope the medication works for you.

[earthwitch]

Yes, I have widespread enthesitis. Its the kind of joint inflammation that goes along with spondyloarthritis usually, rather than RA (which tends to have synovitis more). I have Ankylosing spondylitis, but enthesitis can go with psoriatic arthritis, reactive arthritis or undifferentiated spondyloarthritis. NSAIDs would usually be the first line treatment for it, but antitnfs can make a huge difference as well. DMARDs are less likely to do much for it, except for hands and feet involvement.

[reef in reply to earthwitch]

interesting stuff, thanks. how are you faring with it?

[allanah in reply to earthwitch]

I defo got diagnosed with it with RA. It was extremely painful . I also get synovitis too x

[Barrister]

I have this, also synovitis and PsA. Clemmie

[Hidden]

It is a very common symptom of PsA rather than another condition. I don't know if you've seen this diagram:

ncbi.nlm.nih.gov/pmc/articl...

[reef in reply to Hidden]

thanks postle. interesting how assessment methods and to a certain extent medication have not changed much in the 30 years.

[Hidden in reply to reef]

I was wondering what you meant .... then saw the diagram was dated 1987. I think it's more that the position of entheses - i.e. where tendons join bone - hasn't changed in 30 years! If I can find the same diagram with a good explanation attached, specifically for PsA rather than AS, I'll post the link.

[earthwitch in reply to Hidden]

PsA and AS are both from the same family of diseases - spondyloarthritis, and have more in common with each other (in the way the disease attacks your body) than either do with rheumatoid arthritis - although all of these come into the broader category of "inflamatory arthritis". PsA can have a form where psoriasis is dominant, or a form where axial spondylitis is dominant, in which case its incredibly similar to AS -or of course PsA can be anything along the line in between these. In the US it seems that PsA gets treated far more like AS, whereas in the UK it gets treated more like RA, which kind of surprises me, as very few of the DMARDs work particularly well with PsA.

[reef in reply to earthwitch]

it's interesting that in the US, PsA is treated like SA and in the UK like RA. I wonder what the rate of success (in terms of halting joint damage and pain) compare in both countries. The other day, my brother suggested to me spending sometime in France just in case the PsA treatment is different or perhaps better. I dismissed that but now your comparison of UK & US shows how categorising a disease can mean different and perhaps more effective treatment. Thanks for the info.

[Hidden in reply to earthwitch]

Thanks earthwitch. Sure about PsA being treated more like AS in US? I'm not so sure .... I think there may be variation from state to state plus a lot depends on whether insurers will foot the bill for biologics straight off. I hear of many Americans on DMARDs for longer than they'd like. Having said that, I tend to stick with the view that Mtx etc. have a role to play in peripheral disease - though not for me, sadly. I agree spondy diseases are different from RA & can't see much mileage in ignoring differences. But RA-ers would be able to get on biologics much quicker over here too, if I had my way!

[reef]

thanks to all for the replies. the variety of these joint and tendon disorders is mind boggling!

[Stephenlangtonriley]

Interesting thread as when I was diagnosed with Fibro, I went off and did my own research using all my prior medical history, which 3 consultants, ignored, called irrelevant and the last one said I could not have been diagnosed with OA. It all made me angry enough to do a proper investigation and after much research was pointing in the direction of Enthesitis, I went straight to an opticians to check for Glaucoma, the last symptom is AS. It resulted in yet another appointment with a consultant, I refused to see the other 3 for a variety of attitude and courtesy reasons. The result was a more thorough investigation which confirmed some enthesitis along with all the other symptoms that had been previously diagnosed and a couple of new ones, this has been a very long road and the end is closer but still not yet in sight.

There is very little, good, information available, when you remove all the internet dross, Wikipedia, you tube etc that is out there.

I suppose my point here is that I am being treated with Fibro as my main problem, all the other symptoms being secondary and I still consider that Enthesitis to be the real diagnosis and everything else is just a symptom of it.

It is frustrating that when I describe my symptoms and compare them to a broken down car, they still insist on repairs to the periphery and ignore the cause, which is the engine. I hope they fix me before the engine seizes entirely, the computer has already had an attack (TIA), so the diagnostic systems are failing.

[flow4 in reply to Stephenlangtonriley]

Have you found this website, Stephen? It has been produced by clinical researchers at Leeds University and the teaching hospitals. It's very informative.

enthesis.info

[Stephenlangtonriley]

Thank you, I did my research early last year and didn't find this one back then. It is much more informative and detailed.

I am very grateful, thank you,

steve