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  • Q&A with Australian Health Practitioners

    Why is enthesitis not acknowledged as part of Psoriatic Arthritis?

    Related Topics
    Osteoarthritis Rheumatoid Arthritis
    I have PA in my feet and I am housebound in the colder months. I have been told by 1 rheumie that he can't do thing for feet, a second rheumie has sent me for MRI scans. No synovitis was identified so I was told it is not arthritis. I have now spent a fortune on stress fractures! Prof Gladman, ArthritisResearchUK et al state that enthesitis is part of PA. Part of my MRIs showed tenosynovitis and heel bone edema. Gladman identifies edema, Achilles tenosynovitis and plantar fasciitis as a symptom of PA. I have all of these. I also note that application for biologics is confined to joints and synovitis evidence. Please can someone who understands enthesitis treat me!
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    • Dr Irwin Lim
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    Dr Irwin Lim

    Rheumatologist

    Irwin has been a rheumatologist in Sydney since 2003. He is a co-founder and medical director of BJC Health, which consists of a team of … View Profile

    Actually, involvement of the entheses is considered the hallmark of psoriatic arthritis and associated spondyloarthritis.

    The problem is that psoriatic arthritis can present in so many diverse ways.

    The biologic application you mention is an unfortunate situation where government/PBS rules do not reflect the real world clinical situation.

    In many ways, recalcitrant tendon disease/enthesitis (inflammation of the entheses) can affect people's lives as much or more than joint disease/synovitis.

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