Polymyositis with arthritis.

192 JAPI • VOL. 51 • FEBRUARY 2003 A 33-year-old woman was diagnosed with polymyositis eight years ago and treated with corticosteroids and methotrexate. Three years later she had a relapse of polymyositis. At this time she also developed joint pains involving the small and large joints. The distal interphalangeal (DIP) joints were notably affected with subluxation of the thumb (Fig. 1). Radiographs of the hand revealed extensive periarticular calcification (Fig. 2). The patient tested positive for anti-Jo 1 antibodies. There were no clinical features suggestive of overlap syndrome or mixed connective tissue disease. The patient suffered a second relapse of polymyositis five years after the initial onset of illness. Currently her muscle disease is in remission while the joint pains are persisting.