I have a patient who repeatedly has pain in various joints. The history after it would correspond to a systemic Rheumat. Time swelling at the metacarpophalangeal joint, sometimes shoulder pain. Blood loss with RF, anti-CCP, ANA, ESR, HLA B27, Borrelia, etc. found nothing.

Except hyperlipidemia and Vit. D deficiency NOTHING. Wg pressure points. Fibromyalgia -. Negatively  Anyone have another idea?