Hello doctor,
Hello. I have gone through your history. Well, it seems like you developed a reaction to Enbrel which is quite common as it does flare psoriasis in some patients. Pertaining to your queries: Since you have mentioned only one ankle is swollen, it is not justified taking such a high dose of steroids. Considering the patient is 10-year-old, it will hamper the growth and height of the patient. Firstly, one needs to see, if there is an effusion left or there is synovial thickening due to prolonged inflammation. The thickening will not respond to the injections or the steroids. Also, if only ankle is the problem then, consult an orthopedic and you may want some synovectomy done to relieve the inflammation if the other methods have failed. If 20 mg is not working, it is very less likely higher doses will work. My suggestion is to get orthopedic advice. It is hard to say but normally one year of the swelling can damage the joint. If the disease is too aggressive, may be two months are enough. Always a tough thing to call for. US (ultrasound) of the ankle. Orthopedic intervention.