Summary
Definition
History and exam
Key diagnostic factors
- headache
- polymyalgia rheumatica symptoms
- extremity claudication
- other cranial artery abnormalities
- loss of vision
- jaw claudication
- superficial temporal artery tenderness, thickening, or nodularity
- absent temporal artery pulse
- abnormal fundoscopy
Other diagnostic factors
- systemic symptoms
- neurologic symptoms
- cough, sore throat, hoarseness
- bruit on auscultation
- asymmetric blood pressure
- shoulder tenderness
- limited active range of movement of shoulders and hips
- wrist and knee swelling
- dental pain, tongue pain, or infarction of the tongue
Risk factors
- age ≥50 years
- female sex
- genetic factors
- smoking
- atherosclerosis
- environmental factors
Diagnostic tests
Treatment algorithm
Contributors
Expert advisers
Kenneth J. Warrington, MD
Professor of Medicine
Mayo Clinic College of Medicine
Rochester
MN
Disclosures
KJW’s employer receives payments from Eli Lilly, GSK, and Kiniksa for his role as investigator in giant cell arteritis clinical trials. KJW has conducted consulting work for Sanofi, and received compensation from Roche/Genentech for lecturing. He has received honoraria and consulting fees from Chemocentryx. KJW is an author of a number of references cited in this topic.
Acknowledgements
Dr Kenneth J. Warrington wishes to gratefully acknowledge Dr Eric L. Matteson, a previous contributor to this topic.
Disclosures
ELM’s employer has received 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 topic.
Peer reviewers
Anisha B. Dua, MD, MPH
Associate Professor
Northwestern University Feinberg School of Medicine
Chicago
IL
Disclosures
ABD declares they have paid consultancies from Amgen, Abbvie, Novartis, GSK and Sanofi. ABD is on the board of directors for the Vasculitis Foundation.
Kuntal Chakravarty, FRCP (London), FRCP (Glasgow), FRCP (Ireland), FACP (USA), FACR (USA)
Consultant Rheumatologist
BHRT University Hospital
Queen’s Hospital
Romford
UK
Disclosures
KC declares that he has no competing interests.
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