Giant cell arteritis

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[edit] Discussion of Giant cell arteritis

  • Giant cell arteritis is the most common primary systemic vasculitis
  • Typically affects women who are older than 50 years of age.
  • This pathologic condition affects the primary and secondary branches of the aorta and sometimes the aorta itself.
  • A markedly elevated erythrocyte sedimentation rate is almost always present.

  • There are two common constellations of findings in giant cell arteritis:
    • Temporal arteritis
    • Polymyalgia rheumatica.

  • Symptoms of temporal arteritis include unilateral headache, facial pain, jaw claudication, or loss of vision.
  • Temporal arteritis is a common manifestation of giant cell arteritis and may be confirmed by using temporal artery biopsy.
  • In many patients, the clinical manifestation and laboratory values are suggestive of a diagnosis of temporal arteritis and a biopsy is unnecessary.

  • Histologically, giant cell arteritis appears similar to Takayasu arteritis, showing granulomatous inflammation of arteries with infiltration predominantly by histiocytes, lymphocytes, and multinucleated giant cells.

  • Prompt diagnosis and treatment of giant cell arteritis are important to reduce patient morbidity.
  • In particular, vision loss can last for several hours or may be permanent; as many as 15-20% of patients with giant cell arteritis have permanent loss of vision.

[edit] Imaging Findings for Giant cell arteritis

[edit] Angiography

  • Temporal arteriography may reveal the extent of vessels involved but is generally invasive and not sufficient for detecting milder degrees of vasculitis.

[edit] CT

  • CT angiography is useful for revealing luminal changes, such as stenosis, occlusion, dilation, and aneurysm.
  • CT is also useful for showing mural changes to include wall thickening, calcification and mural thrombi

[edit] US

  • A characteristic gray-scale US finding of giant cell arteritis involvement of the temporal artery is a diffusely thickened hypoechoic arterial wall or halo.
  • Color and spectral Doppler US may depict turbulent flow and stenosis of the affected vessel.

[edit] Images

Patient #1

[edit] See Also

[edit] External Links

Goldminer: Giant cell arteritis

[edit] References for Giant cell arteritis

  • Bau, Jennifer L., Ly, Justin Q., Borstad, Gregory C., Lusk, Joanna D., Seay, Thomas M., Beall, Douglas P. Giant Cell Arteritis. Am. J. Roentgenol. 2003 181: 742.
  • Mark E. Lockhart, and Michelle L. Robbin. Case 58: Giant Cell Arteritis. Radiology 2003 227: 512-515.