Last reviewed: November 2017
Last updated: October  2016

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • constitutional symptoms (e.g., malaise, fever, arthralgia, myalgia)
  • headache and scalp tenderness (giant cell arteritis)
  • visual changes (large-vessel)
  • upper extremity or jaw claudication (large-vessel)
  • asymmetric brachial pulses (large-vessel)
  • bruits (large-vessel)
  • abdominal pain (medium-vessel)
  • foot drop, wrist drop (medium-vessel)
  • cutaneous ulcers (medium-vessel)
  • haematuria (small-vessel)
  • palpable purpura (small-vessel)
  • otorrhoea, ear pain, or muffled sensation in the ears (small-vessel)
  • nasal symptoms (small-vessel)
  • sinus pain (small-vessel)
  • wheeze (small-vessel)
  • haemoptysis (small-vessel)

Risk factors

  • age >50 years
  • white ancestry

Diagnostic investigations

1st investigations to order

  • ESR
  • CRP
  • ANCA
  • serum urea and creatinine
  • urinalysis
  • biopsy of affected tissue
Full details

Investigations to consider

  • conventional angiography or magnetic resonance angiography (MRA)
  • PET scan
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Philip Seo

Associate Professor of Medicine

Director, Fellowship Program

Division of Rheumatology

Johns Hopkins University School of Medicine

Director

The Johns Hopkins Vasculitis Center

Baltimore

MD

Disclosures

PS declares that he has no competing interests.

Peer reviewers VIEW ALL

Assistant Professor of Medicine

Division of Rheumatology and Immunology

Duke University

Durham

NC

Disclosures

MC declares that she has no competing interests.

Consultant Rheumatologist

Department of Rheumatology

Freeman Hospital

Newcastle Upon Tyne

UK

Disclosures

BG declares that she has no competing interests.

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