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| | PMR (Site not responding. Last check: 2007-10-13) |
 | | She may ascribe her problem to muscle weakness or joint pains, but physical examination discloses that symmetrical pain and tenderness of neck, shoulder, and hip muscles are the actual source of any "weakness." There may be some mild arthritis of several peripheral joints, but the rest of the physical examination is negative. |
 | | Perform a complete history and physical examination, particularly of the cervical and lumbar spines and nerve roots (strength, sensation, and deep tendon reflexes in the distal limbs should be intact with PMR). |
 | | Confirm the diagnosis of PMR by palpating tender shoulder muscles (perhaps also hips, and, less commonly, neck). |
| www.ncemi.org /cse/cse0109.htm (384 words) |
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