Etiology *Unknown. Factor *Age between 20 to 45 years *Females 2 or 3 time more than males. *Climate Temperate zones with cold and damp climate. *Heredity It is found that most cases have presence of class 2human leukocyte antigen(HLA) *Septic foci in teeth, gums etc. *Automimmunity : Disturbance of antigen- antibody mechanism is also held responsible in some cases. *Endocrine factor. *Psychological factors Excessive & continuous stress. *Nitritilon Malnourished are more affected. PATHOLOGY It is characterised by swelling of synovial membrane and periarticular tissues,subchondral osteoporsis,erosin of cartilage and bone with wasting of associated muslces and other. SYMPTOMS:- *Initially tiredness,gneral weakness,numbnes and tingling in hands and feet. *Loss of weight and generally debility. *Vasomotor disturbanerbances. And other sing.

Hello there.  I can understand your concern.  These issues should be dealt in person itself. I would suggest you consult a rheumatologist in person for further evaluation and management.  Please do carry all previous reports and other treatment slips. It will be helpful. Best regards. Dr. Anil kumar jain. Bangalore.

Consult a DM rheumatologist or MD medicine.. all changes can not be reverted, new damages can be and needs to be prevented