Temporal arteritis

Question 1

Size of vessels affected

Answer 1

medium and large-sized vessels arteries

Question 2

Age normally affected

Answer 2

> 50 years old, with a peak incidence in patients who are in their 70s.

Question 3

Overlap with which other condition

Answer 3

Polymyalgia rheumatica

Question 4

Clinical features

Answer 4

rapid onset (e.g. < 1 month)
headache
jaw claudication
temporary visual loss - amaurosis fugax
diplopia
tender, palpable temporal artery

also lethargy, depression, low-grade fever, anorexia, night sweats

Question 5

What causes anterior ischemic optic neuropathy ?

Answer 5

occlusion of the posterior ciliary artery (a branch of the ophthalmic artery)

Question 6

Signs of anterior ischaemic optic neuropathy on fundoscopy

Answer 6

swollen pale disc and blurred margins

Question 7

INvestigation findings

Answer 7

raised inflammatory markers
temporal artery biopsy
(skip lesions may be present)
creatine kinase and EMG normal

Question 8

Treatment of temporal arteritis

Answer 8

urgent high-dose steroids
urgent ophthalmology review
bone protection for steroids is required
low-dose aspirin is sometimes given to patients

Question 9

How long should patients wait for an urgent ophthalmology review if they have visual symptoms?

Answer 9

Should be seen same say as some visual symptoms are irreversible