A 28-year-old female patient, 2 years back diagnosed with polymyositis and interstitial lung disease after she was historically presented with diffuse bilateral joint pain,  extremities weakness which she described as difficulty with combing her hair, walking upstairs, and difficulty swallowing. The symptoms stayed for nearly one year before she sought medical attention.  On physical examination which was done 2 years back during her first visit; There was mild tenderness over bilateral hand, wrist, elbow, ankle, and foot joints, with a passive limited range of motion.