Temporal arteritis

Question 1

What is another name for temporal arteritis?

Answer 1

Giant cell arteritis

Question 2

Describe TA?

Answer 2

• Common in the elderly
• Granulomatous arteritis affecting any large/medium sized vessels
• Associated with polymyalgia rheumatica (PMR)
• Symmetrical neck and shoulder girdle pain and stiffness

Question 3

Clinical features of Temporal arteritis?

Answer 3

• Headache
  
  • Temporal/occipital with scalp tenderness
• Jaw pain when talking/chewing
• Amourosis fugax
  
  • Pale, swollen optic disc with haemorrhages
• Weight loss, fatigue, night sweats

Question 4

Name an important complication of TA?

Answer 4

Irreversible bilateral vision loss

Question 5

Describe the diagnostic tests for TA?

Answer 5

• ESR, CRP elevated
• Normocytic, normochromic anaemia
• Temporal artery biopsy
  
  • Skip lesions occur => biopsy may be negative
• Temporal artery US
• ¹⁹FDG PET scan
  
  • Highly specific but low sensitivity

Question 6

Describe the management of TA?

Answer 6

• Prednisolone PO
  
  • Methylprednisolone IV if vision disturbance
• Glucocorticoids often required for 12-24 months

Question 7

Describe the prognosis of TA?

Answer 7

• 2-year steroid course then complete remission
• Reduce steroids once symptoms resolved
• Give PPI, biphosphonates, calcium supplements

Question 8

What features will be present if a patient has polymyalgia rheumatica in conjunction with their temporal arteritis?

Answer 8

• Stiff, painful shoulder movements when walking
• Muscles are non-tender without wasting

Question 9

What is the relationship between Temporal arteritis and polymyalgia rheumatica?

Answer 9

• Can occur simultaneously
• Patients with PMR go on to develop TA
• Considered to be different manifestations of the same underlying disorder