Temporal Arteritis/Giant Cell Arteritis/Cranial arteritis/Horton’s headache:
• inflammatory vascular syndrome that affects mainly the cranial arteries in those >50yrs (10x more common in those >80yrs); F>M; higher incidence in populations of Nordic origin (Scandinavians); HLA and familial studies are not clear on genetic role in aetiology; previous periods of infection have been implicated
• Usually abrupt onset (may be insidious) with headache, jaw & tongue claudication, ear canal pain, loss of vision
• Have similar features to polymyalgia rheumatica. Polymyalgia may be prodromal manifestation of temporal arteritis, but nature association is not fully understood
• Predilection for superficial temporal arteries, but can affect extracranial circulation (eg aortic arch syndrome; claudication of extremities)
• involvement of lower limb is rare with a number of cases described
• arthralgias due to synovitis in up to 10%
• American College of Rheumatology criteria for diagnosis is when 3 of the 5 criteria are present (new symptoms after age of 50; new headache; temporal artery abnormality; elevated ESR; abnormal artery biopsy)
• Self-limiting – up to 12 months, but some may have residual ocular damage.
• high dose corticosteroids main approach to treatment – usually dramatic effect within 72hrs
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