&Systemic Lupus=SLE is a multisystem disease of unknown etiology. Clinical manifestations cover a spectrum from mild to life threatening, and the course may be characterized by acute or chronic exacerbations and remissions. Arthralgias and arthritis are the most common presenting manifestations of SLE. Arthritis may involve any joint, but a symmetric arthritis of the small joints of hands (PIPs and MCPs), wrists and knees is typical, sparing the spine. Arthritis can be evanescent, resolving within 24hrs, or it may be more persistent.  In contrast to RA, the arthritis in SLE is nonerosive and generally nondeforming. In those patients who do appear to have deforming features, such as ulnar deviation, hyperflexion and hyperextension, the deformities are generally reducible( Jaccoud's arthropathy).  There are multiple systemic manifestations as well including rashes (malar rash over cheeks), photosensitivity, mouth sores, serositis, lung, renal, vascular and nervous system involvement.