Presentation A 30-year-old woman presented to her rheumatologist for left foot pain of three weeks’ duration. She was followed for systemic lupus erythematosus manifesting in arthritis and hemolytic anemia, as well as anti-nuclear antibody and Smith antibody positivity, and was treated with hydroxychloroquine and prednisone in the 2.5–10 mg per day range. She was symptom…