Rheumatoid arthritis and spondyloarthrides are autoimmune diseases with variable age spectrum at presentation, multi organ involvement but specifically targeting joints in clinically distinct pattern leading to joint damage, making sometimes patient physical activity limited if timely diagnosis and immediate treatment delayed. Previously clinicians often faced difficulty in making earlier diagnosis of Rheumatological diseases due to lack of understanding of correlation of underlying autoimmunity with such diseases and polymorphic inheritance of associated genes but now definite diagnostic criteria made on extensive clinical research by different Rheumatological societies. Moreover radiological advances make it further easier to diagnose seronegative/asymptomatic cases earlier. Presence of two rheumatological diseases at a time in same person of any age group though rare but chances are here in accordance to Meta analysis of different case studies presenting with symptoms not particular for one Rheumatological disease. We are going to report a case of young female patient initially presented with polyarthritis, diagnosed and treated as RA but later having backache, when investigated further, HLA B27. Radiological features were suggestive of early Sacroillitis.