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  50 F with multiple joint pains and swelling since 5 years  September 13,2023 This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input.  Ankitha Reddy Date of admission of patient : 11/09/2023 Case: This is a case of 50 year old female who presented with multiple joint swelling and pain Chief complaints : Multiple Joint pains  and swelling  History of present illness: Patient was apparantly asymptomatic 5 years ago then she developed swelling in the left knee joint which is insidious in onset gradually progressive it is associated with pain in the knee which was agrravated on walking and doing work and relieved on medication.then she developed pain and  swelling at multiple jo