Diagnosis of giant cell (temporal) arteritis
- Gene G Hunder, MD
Gene G Hunder, MD
- Section Editor — Vasculitis
- Emeritus Consultant
- Professor Emeritus
- Mayo Clinic College of Medicine
- Section Editors
- Jonathan Trobe, MD
Jonathan Trobe, MD
- Section Editor — Ophthalmology
- Professor of Ophthalmology and Visual Sciences
- Professor of Neurology
- University of Michigan Kellogg Eye Center
- Eric L Matteson, MD, MPH
Eric L Matteson, MD, MPH
- Section Editor — Treatment Issues in Rheumatology
- Division of Rheumatology
- Professor of Medicine
- Mayo Clinic College of Medicine
Giant cell arteritis (GCA) is a chronic vasculitis of large- and medium-sized vessels. The mean age at diagnosis is approximately 72 years, and the disease essentially never occurs in individuals younger than 50 . Among individuals older than 50, the prevalence of GCA has been estimated to be 1 in 500 individuals .
Although GCA is characteristically a systemic illness and although vascular involvement may be widespread, symptomatic blood vessel inflammation most frequently involves the cranial branches of the arteries that originate from the aortic arch. The most feared complication of GCA, visual loss, is one potential result of the cranial arteritis associated with this disease.
The diagnosis of GCA will be reviewed here. The pathogenesis, clinical manifestations, and treatment of this disorder are discussed separately. (See "Pathogenesis of giant cell (temporal) arteritis" and "Clinical manifestations of giant cell (temporal) arteritis" and "Treatment of giant cell (temporal) arteritis".)
The diagnosis of giant cell arteritis (GCA) should be considered in a patient over the age of 50 who complains of or is found to have:
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- Temporal artery biopsy
- - Yield of first biopsy
- - Explanations for negative biopsies
- - Biopsy of other arteries
- - Initiating glucocorticoid therapy
- - Predicting results
- - Biopsy-negative GCA
- - Magnetic resonance imaging/angiography
- - Conventional angiography
- - Ultrasonography
- - Positron emission tomography
- CLASSIFICATION CRITERIA
- DIFFERENTIAL DIAGNOSIS
- Large-vessel vasculitides
- Small- and medium-vessel vasculitides
- Central nervous system vasculitis
- Nonvasculitic conditions
- INFORMATION FOR PATIENTS