Case history
Case history
A 58-year-old woman presents with a 2-week history of fatigue, anorexia, fevers, and bilateral pain and stiffness in the shoulder and hip girdles. These symptoms are worse at night. Upon awakening in the morning, she feels as if she has a bad flu. She reports difficulty getting out of bed in the morning due to stiffness. Her wrists and finger joints are also painful and swollen.
Other presentations
Less common peripheral musculoskeletal manifestations include a monoarthritis or polyarthritis, pitting edema of the hand, carpal tunnel syndrome and tenosynovitis.[1] A second presentation is the presence of the characteristic neck, shoulder girdle, and hip girdle symptoms associated with normal serum markers of systemic inflammation (i.e., ESR or CRP).
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