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It is imporatant not to misdiagnose poymyalgia rheumatica in the older patients presenting with bilateral pain and stiffness in the shoulder girdle. The pain radiates towards the lower neck. It may occur following an influenza like illness. In the presence of a normal physical examination they are sometimes misdiagnosed as rheumatics or fibrositis. Steroids give dramatic relief but long term management can be problematic.
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