I am having pain and swelling in both of my hands since 2 months,did x-ray, NCV, Blood test(RF factor , CBC, ESR, HLA B27), everything came normal. First the pain started in left wrist with no swelling, then moved to entire hand and now in both the hands with frequent swelling. Pain starts from elbow n increases towards hand and palm/ fingers, extreme hair fall and occasional fever has started since 2-3 weeks, consulted orthopedic, neurosurgeon and now rheumatologist. Got another blood test done (attached reports) 1.  ANA by immunofluorescence, got borderline nucleolus results. 2. Anti cyclic citrullinated peptide Please suggest what can be the possible reason for these symptoms and reports