Help with foot inflammation
I know this isn’t a medical sub but I don’t trust medical professionals so any insights are much appreciated
CLINICAL PICTURE IN BRIEF
I have a lifelong history of skin psoriasis dating to my teenage years. Approximately one week ago I developed an acute inflammatory flare in my right foot, preceded by new psoriatic plaque activity on my right shin. This is the second such episode — the first occurred three years ago following a left knee fracture. Both episodes share an identical pattern: migratory inflammation tracking along tendons and joint structures of the right foot, with redness, swelling, heat, and morning stiffness. The cumulative clinical picture strongly suggests Psoriatic Arthritis.
KEY CLINICAL INDICATORS FOR PSA
Indicator
Detail
Significance
Lifelong skin psoriasis
Diagnosed teenage years, recurring throughout adulthood
Primary risk factor
Skin preceding joint flare
New plaques on right shin 1-2 weeks before joint symptoms — both episodes
Classic PsA pattern
Migratory enthesitis
Inflammation tracking along tendons, shifting locations across foot and ankle
PsA hallmark
Nail involvement
Longitudinal split of right thumbnail — present several weeks
Recognized PsA sign
Plantar skin changes
White spots along plantar arch appearing and resolving with flare
Possible palmoplantar psoriasis
Spinal involvement
Recurrent low back pain previously attributed to herniated disc — may represent psoriatic spondylitis
Worth evaluating
Asymmetric pattern
Right foot both episodes, right knee injury as trigger — left side unaffected
Consistent with PsA
Failed gout aspiration
Podiatrist aspiration 3 years ago — inconclusive, no crystals extracted
Reduces gout likelihood
Steroid response
10mg prednisone providing meaningful relief of current flare
Consistent with inflammatory arthritis
EPISODE HISTORY
Episode
Trigger
Course
3 years ago
Left knee fracture — skiing
Onset 6 weeks post-injury. Acute right foot inflammation resembling gout. Multiple urgent care and ER visits — inconclusive. Podiatrist aspiration — no crystals. Managed with prednisone on and off. Resolved spontaneously.
Current — ~1 week ago
Heavy alcohol use 2 weeks prior — possible threshold trigger
Preceded by new psoriatic plaques on right shin. Progressive right foot inflammation — diffuse swelling, redness, heat. Migratory pattern across big toe joint, arch tendon, and lateral ankle. Currently managing with 10mg prednisone.
CURRENT MEDICATIONS & SUPPLEMENTS
Item
Detail
Prednisone 10mg
Prescribed via Teladoc — 20mg taper. Currently taking 10mg as providing adequate relief
Magnesium citrate
Regular supplementation
Turmeric / Curcumin
Daily with black pepper
Used sparingly for pain — aware of GI interaction with prednisone, using minimally
RELEVANT MEDICAL & LIFESTYLE HISTORY
• Skin psoriasis — lifelong since teenage years, recurring intermittently
• Herniated disc — diagnosed approximately 6 years ago, managed with PT and core strengthening
• Recurrent low back pain — previously attributed to disc, now considering possible psoriatic spondylitis component
• Hypothyroidism — diagnosed approximately 5 years ago, resolved with dietary changes, levels normalized on retest
• Lyme disease — tested negative approximately 5 years ago, no known tick exposure since
• No current infections, urinary tract issues, or significant gut inflammation
• Non-smoker, not currently drinking alcohol
• Very active lifestyle, health conscious diet, extensive supplement regimen
• No family history of rheumatoid arthritis or confirmed PsA known