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A 61-year-old man was referred to our rheumatology unit with a 3-month history of worsening left-sided neck and shoulder pain. His general practitioner (GP) suspected Giant cell arteritis and a temporal artery biopsy was performed which was negative. Shoulder and neck x-rays were also normal. He had a 40-pack-year smoking history and a chest radiograph was organised by his GP. On questioning, he admitted to significant weight loss and hoarseness of voice. …
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Competing interests None.
Patient consent Obtained.