11 years old female, pain in joints from 1 month moderate, inflammation of elbow,wrist, knee, ankle from 20 days, fever high grade from 4 days, deformity of metacarpal joints from 3 years, TB contact +ve (mother & sibling). O/E: inflammation of elbow, wrist, MCP, wrist, knee & ankle joints symmetrical, warm & tender, nodules on MCP, joints pigeon chest, chest b/l clear, GCS 15/15, anterior fontanelle wide open. Ix: WBC 12, HB 10, plt 394, Spinal XRay shows mild Kyphosis, Platyspondyly at lumbosacral joint, ASOT -ve, XRay both hand & feet shows soft tissue calcification, bone density mildly reduced, USG joints: no joint effusion. Diagnosis & Management?

7 yr boy with multiple joint pain and swelling since 4 yrs on off fever Anemic with hepatosplenomegaly. high ESR ANTI CCP NEGATIVE RA FACTOR NEGATIVE ALL REPORTS ATTACHED PLEASE ADVICE

pt age of 14 yrs male pt having swelling on rt knee jt since last 8 yrs but now swelling on both knee jt pain no fluid in knee there is kat kat noise on moving pt become weak wt below 40kg pt is now walking no other involvement of other joint pls all drs and mams whats the diagnose and remedy

9 year's old girl came with parents inflammation and swelling of left hand elbow joint. *Chief Complaints* Pain in left elbow joint. *History* History of traumatic from bicycle *Physical Examination* Inflammation and swelling of elbow joint. And severe pain feeling when the joint flod or move hand. *Investigations* X-RAY attached *Diagnosis* Please suggest *Management* Please suggest

7 yrs old boy with no mental retardation, since birth spot diagnosis