55 years old female patient , suffering from polyarthralgia (especially knee joint) since 2 years. CBC normal , Hb - 12.3 , ESR - 30 , C reactive protein - 16.8 , S.Uric acid - 5.56 , RA factor - 19.4 , Vimin B12 - 762 , Vitamin D - 19.5. S.creatinine - 0.8 TSH - 2.03 I have started calcirol granules once in a week , Shelcal HD OD , febuxostat 40 mg BD , and multimineral and multivitamin tablet and Naproxen 500 mg sos. patient is not complaining typical bilateral joint pain in morning hours.
there is no history of fever. How to rule out RA? Is RA factor value is significant ? Should I continue the treatment ?
