Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • headache
  • polymyalgia rheumatica symptoms
  • loss of vision
  • jaw claudication
  • extremity claudication
  • superficial temporal artery tenderness, thickening, or nodularity
  • absent temporal artery pulse
  • other cranial artery abnormalities
  • abnormal fundoscopy

Other diagnostic factors

  • systemic symptoms
  • neurologic symptoms
  • cough, sore throat, hoarseness
  • bruit on auscultation
  • asymmetric BP
  • shoulder tenderness
  • limited active range of movement of shoulders and hips
  • wrist and knee swelling

Risk factors

  • age >50 years
  • female sex
  • genetic factors
  • smoking
  • atherosclerosis
  • environmental factors

Diagnostic investigations

1st investigations to order

  • ESR
  • C-reactive protein (CRP)
  • CBC
  • LFTs
  • temporal artery biopsy
  • temporal artery ultrasound
Full details

Investigations to consider

  • aortic arch angiography
Full details

Emerging tests

  • FDG-PET scan of head to mid-thigh
  • ultrasound scan of the upper extremity arteries
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Kenneth J. Warrington

Professor of Medicine

Mayo Clinic College of Medicine

Rochester

MN

Disclosures

KJW is an author of a number of references cited in this monograph.

Eric L. Matteson

Professor of Medicine

Mayo Clinic College of Medicine

Rochester

MN

Disclosures

ELM’s employer receives payments from Bristol Meyers Squibb and GlaxoSmithKline for his role as investigator in giant cell arteritis clinical trials; from Novartis for his role in polymyalgia rheumatica clinical trials; and from GlaxoSmithKline for his role as an advisory consultant. ELM is an author and editor for Up To Date and Paradigm, as well as an author of a number of references cited in this monograph.

Peer reviewers VIEW ALL

Professor of Rheumatology

Mayo Clinic

Rochester

MN

Disclosures

GH declares that he has no competing interests.

Consultant Rheumatologist

BHRT University Hospital

Queen’s Hospital

Romford

UK

Disclosures

KC declares that he has no competing interests.

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