Her other joints have normal range of motion. Her skin is warm with brisk capillary refill. There are irregularly shaped hyperpigmented macules along her lower extremities and abdomen with firm subcutaneous nodules scattered along her lateral lower extremities and hips. There are no bruises. No cranial nerve deficits are noted.
Sensation is intact.
Plantars are downgoing bilaterally. Cerebellar function is intact. Radiographs of her painful lower extremities are obtained. These radiographs demonstrate extensive soft tissue calcifications. The calcifications do not follow any particular vascular pattern and are not attached to bone.