Initially started in left knee joint 12 years back ,from then relapses and remissions of both knee joint pain ,mild pain aggravated with running or jumping,no tenderness no swelling no fever.severe popping of knee joints started when pain started in knee joints.pip and dip pain in both hands since six years,wrist pain since 4 years,cervical neck pain since lyr,elbow since 6 months,sacro iliac joint pain since four months,H/o 2 episodes of myalgia each lasted for four days one year back.All joints on and off episodes ,no tenderness no swelling no fever.frequency duration and intensity of pain episodes slightly increased.No skin lesions and no other complaints.Family history of psoriatic lesions present.Fours years back MRI ,crp,ana,cbp,uric acid,ra factor normal.esr four years back was 25.but later became normal.now it was 40 done one week back.x ray wrist and knee normal.popping of phalangeal joints also present.My self Dr.D.pavan Kumar MD general medicine.planning to meet rheumatolog