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43F with polyarthritis and sacroileitis

 Chief Complaint: Joint pains since 2months ago , Swelling and stiffness 2 months ago  History of present illness(HOPI): The patient was apparently asymptomatic since 1year ago.Later she developed body pains and Joint pains. The pain was insidious in onset,non progressive, intermittent which is dragging and burning associated with fever(during body pains)and swelling overproximal interphalyngeal joints.Pain is more during morning hours and decreases as day progresses.  Past History: H/O : Rotator cuff surgery since 2 years ago  Operated following which fresh arthritis of other joints including sacroiliac began.  H/O Hypertension N/K/C/O Diabete Mellitus,Tuberculosis, Epilepsy,Thyroid Disorders  Personal History: Diet _ Mixed Appetite: good  Sleep:Inadequate  Bowel bladder movements:Regular  No Addictions

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