Afemale patient age 40year.she has R.A.Test.positive.Taking Rheumatologist tt since last 5years.which include HcQs +Deflacort6mg in tapering dose +folitrx5mg.+pain killer sos. Came my madhav baug opd today. She has swollen shoulder with deformity in same elbow joint. Also pain in other joint. On examination she has B. M. I 22.94.Bp130/90.No other complaints want to free from this arhritc pain. It is not possible to her to do her regular work without medicine. Ihave suggested following investigations cbc R. A. Test Uric acid sr creatinine. And also start medicine Flexit 2bd+rasna7 and advise her to come with blood report. So that meanwhile we discuss this case on askme For guidance for further tt. Please guide for further tt.