In EUSTAR database, symptoms of arthritis were reported in 16% of patients and they were more prevalent in dcSSc than lcSSc (20% vs 13%), and arthritis detected on radiography in 18% of patients.5,6 Furthermore, muscle weakness and CPK elevation were reported in about 28.3% and 7.1% of all patients, respectively.25 Similar to the EUSTAR study, we detected muscle weakness in 28.1% of the patients.6 In our study, most patients with elevated CPK and aldolase were among those with muscle weakness, and muscle enzyme test can be useful as a diagnostic tool. Here, PIK3C2A is linked to arthritic joint disease.