<prompt> A 54 year old smoker man comes with severe hemoptysis weight loss and oligoahritis. Serial skiagram shows fleeting opacities. What is the diagnosis?Allergic bronchopulmonary aspergillosisCa lungTbAll  <response>: Answer is A Allergic bronchopulmonary aspergillosis: The presence of fleeting opacities on serial skiagrams is consistent with a diagnosis of Allergic bronchopulmonary Aspergillosis and Wegners granulomatosis. Associated Oligoahritis however ours a diagnosis of Wegeners granulomatosis which is the single best answer of choice. Oligoaicular Ahritis is a feature of Wegners granulomatosis and is not mentioned as a feature of ABPA. Pauciaicular oligoaicular or Polyaicular ahritis may be seen in Wegners granulomatosis. - Current Rheumatology 2nd276, 279 Presence of fleeting opacities may be seen in ABPA and Wegners granulomatosis Fleeting opacities in ABPA Fleeting opacities in Wegners Patients with ABPA typically have Focal infiltrates which may be fleeting fleeting infiltrates on chest X-ray are seen -- Radiology of Chest Disease -- Crofton and Douglas Respiratory Diseases The presence of Oligoaicular ahritis and age of presentation our a diagnosis of Wegeners granulomatosis. 