BMJ Case Reports 2017; doi:10.1136/bcr-2017-220969
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Shoulder pain in smokers could be a life changer

  1. Abrar Alharbi
  1. Department of Internal Medicine, King Abdullah Medical City, Mecca, Saudi Arabia
  1. Correspondence to Dr Ahmed Sayeed, sayeedheena{at}, sayeedmodi{at}
  • Accepted 20 May 2017
  • Published 13 June 2017

Case history

A 51-year-old Saudi man presented to us with a 4-week history of right shoulder and chest pain radiating to the back. He also had distal and proximal muscle weakness of the right upper limb.

He is a chronic smoker for 40 years, about three packs per day. His lifetime exposure to tobacco was 120 pack years. He lost about 3 kg in the last 1 week. There was no history of cough or shortness of breath or fever with night sweats.

He had a history of pulmonary tuberculosis 28 years ago and taken complete treatment for 1 year.

On examination, there was ptosis, enophthalmos, …

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