A 28 years old young woman, referred to me for diagnosis of her joints swelling occurred during pregnancy two years ago. She had a normal delivery and had no pain in her small joints of hands, only swelling, palpable fluid (or spongy tissue like material) in all joints of hands. Knees are markedly swollen with fluid palpable and pains in morning and evening, but not in afternoon.
There is a swelling at and below ankle joint. She came with 70 ESR and normal CBC, urine and getting Methotrexate, not responding to any treatment. What may be the cause of her swelling in joints and what tests recommended ?
