Three weeks ago I broke my pinkie toe. I have been wearing a “boot” for a week and a half since it had not started healing yet. I assume that is from the mtx. My question is this: in the past week my toes, foot and ankle have started swelling up. Is this a start of a flare caused by the broken bone? I am still learning how my body is going to react with the disease and taking the mtx.
Well, I am convinced that my PsA started after a really bad fall on ice and I cracked my tailbone. After that, I started getting pain in my shins and my knees and it was downhill for twenty years. I've heard other people say that they've had terrible flares after things like car accidents. It's a strange disease, this one that we have.
I don’t see why not. Although the immobilization may be the more immediate cause, as you pointed out that the swelling didn’t start until after you started wearing the boot. I hope you heal fast. I broke my little toe a few months ago. For such a little thing it can certainly cause a lot of trouble.
Thanks for the replies. I also wondered if the immobilization from the boot might be the problem. I guess I will just have to give it time and see how it goes.
Like Seenie, I'm convinced my PsA problems started after an injury - in my case it was sesamoiditis on both feet last year. After some weeks of just sesamoiditis, the swelling, enthesitis and more fun came.
See http://www.papaa.org/articles/koebners-phenomenon
The study author’s concluded that "…a number of environmental exposures associated with the onset of IA in subjects with psoriasis. The strongest associations were with trauma thereby adding to the hypothesis of a 'deep Koebner phenomenon'…" and "…in PsA our data also suggest that exposure of the immune system to certain infection related triggers may also be of relevance…"
and
https://jrheum.com/subscribers/08/11/2085.html
"In conclusion, physical injury is one of the environmental factors that can influence the expression of psoriatic diseaseInvestigations on the pathogenetic mechanisms involved in trauma-induced manifestations will lead to a better understanding of the disease."
There are some recent journal articles to this as well, but alas I for one cannot access them for free :)
Unifocal psoriatic arthritis development in identical twins followi...
and
Can traumatic injury trigger psoriatic arthritis? A review of the l...
Hey, RyanF, great articles. I’d seen the ones mentioning “deep koebner” from papaa before (BTW, papaa has great site.) The others look interesting too, and sometimes we have members who have access to them and can pass on the most important bits.
My diagnosis came from a rib that dislocated many times in the past but when it happened in July it just would not heal. I have no family history of this or anything close to it so I am confident in saying an injury can definitely bring this disease out. Always much to any story but that’s the basics. Hoping things get better for you soon.