Presented with pain in multiple joints (shoulder, elbow, knee, wrist, pharyngeal joints, ankle, PIPs) specifically in knee joint, elbow joint and back for 4 months continuously. Pain is more in larger joints than smaller joints. No fever no headache no physical injury. He wakes up with stiff joints which increases with physical activity. He had been on painkillers and showed no improvement at all. Kindly guide me with the possible diagnosis and recommendations.
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