Psoriatic Arthritis and Trigger Finger

jamieA

I had an appointment with an orthopaedics consultant today regarding my trigger fingers which were diagnosed 18 months before I was diagnosed with PsA. This is the 3rd time I've seen this particular consultant in the last year but today he surprised me when he said that PsA and trigger finger go hand in hand - no pun intended. I'd never thought of it as my trigger finger had been diagnosed 18 months before my PsA diagnosis. Having now searched it does indeed appear quite a common link particularly with PsA sufferers who also have enthesitis (as I have). My trigger fingers hadn't triggered since late 2020 when I was given steroid injections into the base of my fingers. However in late 2022 it returned - that coincided with me not needing general steroid injections for my PsA and enthesitis. I think now the regular general steroid injections I was given in my rump through 2021 and early 2022 were actually helping the trigger finger. The consultant today gave me a steroid injection into the base of my worst finger but said that would need be the last as they only give a maximum of two per finger as multiple injections can cause the sheath round the tendon to collapse. The problem for me is that the trigger fingers are on my left hand and I'm left handed.

Hairobsessed123

Hi @jamieA

just searched trigger finger and your post popped up !!!
had an appointment thought I was flaring and the consultant scanned me and I have fluid around a knuckle and he said it’s like trigger finger and have me a shot right into the tendon sheath !! Ouch 😣 but my arthritis is still in remission I didn’t know these went hand in hand !!

jamieA

Hi @Hairobsessed123

Have you been diagnosed with enthesitis as well as PsA? From what I've read PsA sufferers who also have enthesitis are more likely to suffer trigger finger. I know from your posts in the past you've had tennis elbow and plantar fasciitis symptoms which I also get. I was diagnosed with tennis elbow and plantar fasciitis in the last 10 years before being diagnosed with PsA and enthesitis and had been diagnosed with carpal tunnel syndrome many years previously. My rheumatologist has said these are actually enthesitis pains. My heels, right wrist and right elbow are particularly aching just now.

My trigger fingers are ok just now. The orthopaedics consultant said he wouldn't give me another steroid injection into the finger he did in February as there's a chance the sheath surrounding the tendon will collapse with repeated direct injections.

I do find it a bit crazy that I'm being seen by an orthopaedics consultant for my trigger finger which he has stated is connected to my PsA and enthesitis, yet it's my rheumatologist that's dealing with the enthesitis in my wrist, heels and elbow.

Hairobsessed123

@jamieA yes I was diagnosed with enthesis on the MRI I had !
He hasn’t mentioned this thou !
sorry for such a late reply my steroid injection worked a treat ! I had a video consult yesterday and I have to now have a hip X-ray and spine mri I’m having a few niggles but other than that I’m still doing really well !
Hope your taking care x

jamieA

Hi @Hairobsessed123

My enthesitis causes my right lower arm to swell particularly overnight. I'm left handed so wear my watch on my right wrist. I took a heart complaint after I was diagnosed with PsA so wear a watch that monitors my heart rate - so I wear it 24/7. Regularly I wake in the morning with it tight on my wrist as the wrist has swollen overnight. It usually returns to normal once I'm up and about. However the enthesitis is becoming more of a problem and I'm struggling to lift things and rotate my arm - for instance trying to drink from a cup using my right hand is an issue both at the wrist and elbow. I saw a rheumatology nurse last month and she referred me for x-rays on the same day of my right elbow and wrist. She said that the enthesitis should be controlled by the adalimumab biologic I take and that this might be a sign I may be building antibodies to the biologic so she took blood to test for this. I'm still waiting for the outcome of the x-rays and blood tests. She didn't want me to have a steroid injection as I'd had one 3 months previously.

It's good you are still in remission and hope it continues.