Palindromic rheumatism. Range 0- 15)

Patient is male child of 12 years. Had severe pain on thigh 2 and half years back. had pain on arms and bicesps also. the pain was less frequent upto the last 2 months. it has been more frequent from the last two months (almost daily). the pain is on hands, wrists, ankles, muscles of upper extremities (on and off). episodic painful in all extremities in two years. The doctor says it is Palindromic Rheumatism. Doctor prescribed Oncotrex (10 mg/week) and folic twice a week (5mg×2/week) i.e. consecutive two days) and vitamin 60 KD (1capsule/week). The patient is taking the medicene for last 1 month. But still feels pain but is less frequent. test of blood result recent: 1. anti ccp 175 U/ml (ref range less than 25) 2. rf factor quantitative 4.4 IU/ml (ref range less than 20) 3.esr 20 (ref range 0- 15)