help me diagnose

[awesomeman]

My gamble is for the latter, I think it is arthritis, Psoriatic Arthritis
It is an odd place though, one would expect it to be in the smaller joints of hands and feet.

Humira should have prevented it, but there are many people that after some time fail on Humira.

But... it could also be caused by the biological. It may be that the biological lowers a certain part of your immune system, thus giving that specific form of inflammation a chance. Apparantly it has no bacterial source as otherwise they would be able to find that.

IT also happened exactly 12 months apart.  I just have a feeling its from a biologic.  I just reviewed the old labs and noticed that the sample was inconclusive for crystals and bacteria.  My neutrophil count was elevated quite a bit.