PAIN ALONG LEFT UPPER LIMB 29 YEARS OLD FEMALE WITH C/O 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 HOPI.: 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 muscle weakness manifested in the fo