Is a case of Rheumatoid arthritis?

Middle age man Chief Complaints Joints pain and muscles pain for 4 months Mouth and tongue ulcers for 2 weeks Not associated with fever and others History H/o Hep. B +very Vitals Alright Physical Examination Weak Investigations LFT, KFT RBS , S.URIC acid CBC all normal Diagnosis Is a case of Rheumatoid Arthritis ?? D/dx and Dx ? Management ????

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Do a proper examination.. The joints involved, especially small joints of hand. Whether they are symmetric or not. Calculate total no of joints involved. RA probability is more if the duration of pain is more than 6 months. Do ESR, CRP and anti CCP. If RA factor is more than 3 times UNL then probability of RA is more. Also perform Xray of the involved joints and look for juxta articular erosions or osteopenia. Start with Tab Indomethacin 35 mg BD until other reports become available.

Thank you doctor
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