42-year-old male complains of A progressive loss of weight 5-7 kg over 1 year Morning stiffness and pain of muscles of the body especially calf muscle after waking up Morning asthenia Tiredness Small joint pains Muscle pain initially at calf and thighs and later arm muscle Loss of muscle bulk The duration of symptoms are for more than 6 months and progressive. He felt a feverish sensation for 1 month. All these symptoms aggravated for the past 20 days with recurrent balanoposthitis of penis not responded to antifungal treatment.
During this time he developed effusion of the knee joint unilateral slow growing. Later subsided in a few days. Hypothyroidism for 5 years on tab Eltroxin 25 Past h/o axillary lymph nodes TB 20 yrs with drug-resistant M.tb - Received 9 month of treatment Nonhypertensive and no DM No evidence of hypermobility of joints and no tender points of muscle.…
