Pitfalls in interpretation: calcium that's not bone.

This is a 65-yr-old woman with dermatomyositis and extensive calcinosis. On physical examination subcutaneous nodules were widely distributed on her chest and extremities. Her current CPK is 163 IU/L (normal range 0-175); however, with a recent flare of her symptoms, the CPK peaked at 411 IU/L. Her current medications are Imuran 25 mg/d, Prednisone 4 mg/d, and conjugated equine estrogen 0.625 mg/d.