An 8 year old girl with pauci-articular juvenile rheumatoid arthritis associated with positive antinuclear antibodies testing, arrived in the emergency department with severe right knee pain after a fall on both knees four days earlier. She had developed bilateral bruising with swelling and limited range of motion of the right knee, with no fever. She was found on plain x ray examination to have calcifications in joints injected previously with steroids. The girl was treated with a non-steroidal anti-inflammatory drug and the pain resolved after few days.