Temporal arteritis

Question 1

What is temporal arteritis?

Answer 1

Systemic granulomatous vasculitis affecting large and medium sized vessels

Question 2

What are risk factors for temporal arteritis?

Answer 2

Age > 50
Female
Polymyalgia rheumatica
White

Question 3

What are clinical features of temporal arteritis?

Answer 3

Temporal headache
temporal artery tenderness, thickening, redness
Visual changes e.g. diplopia, amaurosis fugax
Jaw claudication
PMR Sx e.g. shoulder and pelvic girdle pain
Neurological sx e.g. mono/polyneuropathy in arms or legs, TIA, stroke

Question 4

What Ix for temporal arteritis?

Answer 4

Bloods: ESR and CRP raised, Low Hb

temporal artery biopsy

temporal artery US: halo sign. Non-invasive and avoids missing skip lesions

Question 5

Rx of temporal arteritis?

Answer 5

If visual Sx: oral pred, IV methylpred.

Ongoing: oral pred, taper it down. Bone protection. Steroid sparing e.g. MTX if disease relapse, SE

Aspirin: reduces ischaemic complications

Question 6

Complications of temporal arteritis?

Answer 6

Visual loss

Large vessel vasculitis e.g. vascular stenoses and aneurysms

CVA