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How u manage this case
Mrs A patient female pt 30 yrs old with Aso titre 221 . HLA B27 positive CRP 5.03 RA factor more than 20 hb 9.5 with normal thyroid and egfr complaints of severe back muscle spasm in the morning after awkening for about 1 hour.
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Check ur blood anti ccp level. Start medicine as  DMARDs.
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