57 year old African-American female with prior medical history of hypertension, hyperlipidemia, asthma, and osteoarthritis presented to the hospital with four months of increasing muscle weakness and pain. She had previously been evaluated at a different hospital one month prior, after she lost the ability to ambulate without a walker, where she received no concrete diagnosis and had minimal improvement in her condition. Patient presented to our institution after she suffered from a fall due to worsening symptoms. Upon admission, it was noted that the patient had hyperpigmentation on the DIP and PIP joints consistent with Gottron papules, and facial hyperpigmentation, raising concern for dermatomyositis. Additional findings included bilateral upper and lower extremity weakness (proximal greater than distal), and work up showed leukopenia, elevated CK, highly positive ANA/RF. Thigh biopsy showing necrotic myofibers with foci of perifascicular atrophy, and positive HLA Class I immunohistochemistry. Over the course of admission, the patient was treated with steroids, IVIG, and mycophenolate mofetil, as well as daily PT sessions. Her symptoms gradually improved, with increased strength and independence in ambulation. Patient was discharged to a rehabilitation center with rheumatological follow up.