### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am having fatigue and pain in my joints, mostly my hands and hips. About eight months ago I had a bout of facial muscle twitching, a severe headache behind my right eye and double vision. I did have an MRI that showed some lesions that were questionable for MS. Follow up MRI was recommended I just havent went back to neurology as they really dont do anything as I am asymptomatic at this point but I think this joint pain stuff is separate and different that the previous problems. What are your thoughts. I just hate going to see someone because the few times I have sought medical attention nothing conclusive is ever found and it ends up being a waste of my time.

### output:

Hi, thank you for providing the brief history of you. A thorough clinical neuromuscular and musculoskeletal assessment is advised. As you had a previous MRI, we need to understand the report and also the clinical signs and symptoms too. As you age also should give us some input. To be practical, that 90% of MRI taken will not be having a normal results. So worrying about having an MS should be first removed from the mind. Also, the fatigue can be due to another factor and needs an understanding. It may be due to reduced physical activity of may be due to not a proper diet. A neurologist should assess you initially and go through all the physical examination, chief complaint and diagnostic reports. Understanding that MRI can not be a perfect diagnosis as well. Also, many of the Neurological condition will have similar symptoms and to make a differential diagnosis is needed, without whicChatDoctoring to a straight conclusion is not ethical. As you had double vision, fatigue, headache etc. we need to perform a proper clinical examination and also the chief complains or the past medical history, family history etc. Much More understanding happens if listened to you initially about you.Also, for fatigue you need a proper diet and proper physical exercise to improve the metabolism and immune system as well. Pain and aches in the joints can be Due to lactic acid which is formed at the end of each glycolysis cycle which is the base for the activation of muscle. Also, I will recommend you to perform breathing exercises, meditation and physical exercise which will make all the possible things turn down. In my clinical practice I have seen many cases which have a combination of complaints and also after proper assessment and understanding of the case we recommend physical therapy, and They respond wellRegardsJay In Chat Doctor. 