can some one help me , as i am bit confussed regarding one diagnosis, complains are as follows
pt is a female of 24 years , complaing of multiple joint pain including interphalengial joints , wrist, shoulder,scapular region,and neck, she also complains of occational knee pain,she complains of swelling over face in morning whilw awakening that goes on gradually as day advances., RA test is Negetive, firstly i thought if cervical Wikipedia reference-linkspondylosis, so i started treatement with SWD in scapular region, and Us over Trepezius, but as i tried to give traction uar glides she complainof pain in scapular and neck as the tracion pad atretches, i am bit confussed so i t\ recommended her for serum creatinin test , whose result was 1.02 which is on upper limit , so wht i think is that the pains are due to elevetd serum creatinine and facial edema also, what is ur opinion.