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Giant Cell Arteritis — SCE Rheumatology MCQ

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HardVasculitisGiant Cell ArteritisSCE Rheumatology

A woman has a high clinical probability of giant cell arteritis. Glucocorticoids have started, but temporal-artery biopsy is negative. What is the best interpretation?

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Correct answer: A — Integrate clinical probability, biopsy limitations and vascular imaging

The best answer is “Integrate clinical probability, biopsy limitations and vascular imaging”. A negative temporal-artery biopsy does not exclude giant cell arteritis because inflammation can be segmental and prior treatment may reduce yield. Management should integrate pre-test probability and vascular imaging rather than stop treatment automatically, relabel the illness, require bilateral biopsy in every patient or infer a non-inflammatory headache.

Reference: BSR giant cell arteritis guideline: https://academic.oup.com/rheumatology/article/59/3/e1/5714024