A 29 year female patient with complaints of joint pain
29 years old female homemaker by occupation came to the General Medicine OPD with the Chief complaint:- - B/L joint pains (knees) since 10 months - B/L itching in the upper aspect of chest and neck since 10 months History of present illness: —> Patient was apparently asymptomatic 10 months ago. Then she developed symmetrical b/l joint pains in the knees which was insidious in onset, gradually progressive, no aggravating factors and relieved on medication i.e. TAB. HYDROXYCHLOROQUINE 200 mg Associated with morning stiffness. — Around the same time she developed itching over neck and upper chest area. As a result of the itching, the area was initially red and turned black. — C/O Alopecia since 10 months. It was gradually progressive leading to severe hair loss over the past 10 months. Associated with thinning of hair. — C/O bilateral pitting type of pedal Edema and Edema over the dorsal aspect of hands. — C/O generalised pain. — C/O Difficulty in walking. — C/O distal