9-year-old girl presented with Gottron’s sign, V sign, shawl sign, proximal muscle weakness, elevated muscle enzymes, ANA 4+ Nuclear Fine Spcekled, and anti-SAE3 positivity, consistent with juvenile dermatomyositis. Despite corticosteroids and methotrexate, she developed extensive calcinosis involving the limbs, chest wall, and face, with progressive contractures, requiring escalation to IVIG, tofacitinib, and pamidronate.