Caplan Syndrome is an inflammatory reactive pulmonary condition to dust in a patient with Rheumatoid arthritis due to exposure to coal/silica/asbestos. It may be associated with any other diseases. SUMMARY A case of Caplan Syndrome in a 74-year-old female, known diabetic, know rheumatoid arthritis Patient, who presented with breathlessness and fever. Her X-ray showed unusual opacities on right side, and spine x-ray showed compression fracture of T10.Dexa scan was done. Patient was discharged from hospital after improving symptomatically. Thus, a diagnosis of Caplan syndrome and osteoporosis was done.