D/Dx of chronic small joint pains of hands and feet without any local signs in middle aged female?

20 year old male presented to orthopedic opd for evaluation of joint pain and swelling for last 3 years , started with left elbow joint and resulted in severe pain swelling and later a flexion deformity.Following this, bilateral great toes got affected with pain and swelling following which there was discharge of chalky white material from the toes later it progressed to bilateral knee and then to hips and then to bilateral wrist joints and small joints of hand.The patient's CBC shows decreased hemoglobin levels , platelets , TLC within normal limits , LFT , KFT normal with increased uric acid levels only around 16.14 serum calcium was normal and PTH was also normal , RA Factor slightly elevated at 12 , Anti ccp awaited. Xray as follows@

66 y/o female with the following changes on the hands present for past 5 years. Also has left hip pain, low back pain, and feels stiffness and pain in the hands. How will you diagnose this case?

A 62 year male patient routenly diagnosed HTN(170/90) without any symptoms, CRP and HS CRP are as follows, pt also have history of arthritis.. Please suggest Tx regimen.. further diagnostic evaluation???

70 yr f polyartharlgia.thin built.initially painful swelling on fingertips .lesions since 1yr.ddx ?gout.vasculiris.lab awaited

78 year old man presented with severe, progressive pain of the great toe with limitation of motion leading to difficulty walking. Radiographs are posted. What is the cause for pain.