Please enable JavaScript.
Coggle requires JavaScript to display documents.
Giant cell arteritis (GCA) (Clinical presentation (Headache (Character …
Giant cell arteritis
(GCA)
Definition
Vasculitic disorder
Epidemiology
Elderly
F>M
Pathophysiology
Vasculitis of large arteries
Inflammation causing pain and thrombi
Clinical
presentation
Headache
Character
Tender on palpation
Radiation
Nil
Onset
Usually insidious
Associated symptoms
Jaw claudication, fever, tender scalp,
amaurosis fugax, morning stiffness
Site
Temporal region
Timing
Intermittent
Exacerbating
Exacerbating: palpation of temporal
Relieving: steroids
Severity
Variable
Jaw claudication
Amaurosis fugax
(sudden blind one eye)
Fever
Morning stiffness
(usually girdle)
SOB
Diagnosis
Examination
Neuro (CN): tender, thick and pulseless temp arteries
Musc: reduced ROM of shoulder/hip girdle
Investigations
Bedside
Obs: may have fever
Bloods
CRP/ESR (raised)
FBC (anaemia, thrombocytopenia),
U+Es, LFTs (ALP may be high)
Biopsy
Diagnostic
Skip lesions common
History
PC: headache, jaw, visual loss,
girdle stiffness (shoulder, hip)
PMH: signs of systemic disease
Management
Intitial ABCDE
Definitive
Medical
High dose steroids e.g. prednisolone
Taper dose once symptoms and ESR resolved
Gastric and bone protection
Referral
Ophthalmologist if visual symptoms
Complications
Irreversible
visual loss
Complications
from steroids
Prognosis
2y then remission