Q: Three months ago month my ESR was 54 mm and this month it is 95 mm. Now I am much better. I had joint pains in knee and elbow joints. I was diagnosed as a case of rheumatoid arthritis on the basis of morning stiffness which I still have in elbow joint and knee joints. There is no visible swelling now but in the wrist joint there was swelling earlier. The physician on checkup found the joints normal and there was no swelling. Earlier I had pain in my knees, feet, wrists and finger joints. I was advised chloroquine (250 mg/day) and as a painkiller nefroxen but I prefer nimesulide as others don't bring my fever down. Should I start chloroquine and for how long I have to continue it as I am apprehensive about its side effects.

A:Rheumatoid arthritis is a serious systemic disease that requires detailed assessment to see the severity and the extent of the disease and measure the factors that decide prognosis (i.e. what will be its future course). After staging of the disease is carried out, then it is decided what medicines would be the best treatment for that patient. It is a complicated process and requires highly specialised doctors called rheumatologists. Your disease appears to be in a very early stage when it can be completely controlled by some wonderful new drugs. Just taking nimesulide or naproxen to control pains/fever or to take only a few tablets of chloroquine is usually not the way one treats rheumatoid arthritis. You must see a qualified rheumatologist specialists in joint diseases). Remember, in early stage it can be fully treated. On the other hand if it becomes late, then major problems may arise.