Temporal Arteritis

Question 1

What is temporal arteritis?

Answer 1

Large vessel vasculitis which overlaps with polymyalgia rheumatica (PMR)

Question 2

What are the features of temporal arteritis?

Answer 2

• > 60 years old
• rapid onset (<1month)
• headache
• Jaw claudication
• visual disturbances
• tender, palpable temporal artery
• 50% have features of polymyalgia rheumatica with morning stiffness in legs

Question 3

What investigations are done to confirm temporal arteritis?

Answer 3

*raised inflammatory markers
»ESR > 50 mm/hr (note ESR
<30 in 10% of patients)
»CRP may also be elevated

*temporal artery biopsy

*skip lesions may be present
note creatine kinase and EMG normal

Question 4

What is the treatment of temporal arteritis?

Answer 4

*high-dose prednisolone
»there should be a dramatic response, if not the diagnosis should be reconsidered

*urgent ophthalmology review
patients with visual symptoms should be seen the same-day by an ophthalmologist
visual damage is often irreversible