Abstract
A 75-year-old male presented with worsening lower limb muscle weakness and was initially treated for infection, as blood tests showed high CRP and WBC levels. However, CRP levels remained persistently elevated without improvement. Further investigations revealed a positive Mi2a antibody, suggesting myositis despite normal CK levels. MRI of the lower limb showed increased signalling in the right tibialis anterior muscle, consistent with inflammation and a biopsy confirmed the diagnosis. This case highlights an atypical presentation of myositis with normal CK levels affecting distal limbs. It underscores the need for thorough evaluation in elderly patients to prevent misdiagnosis as sarcopenia or chronic fatigue syndrome, allowing for effective treatment and improved quality of life.