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PET Timing Steroids GCA — SCE Rheumatology MCQ

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HardMusculoskeletal ImagingPET Timing Steroids GCASCE Rheumatology

A 70-year-old with suspected large-vessel giant cell arteritis has started glucocorticoids. If FDG PET-CT is required, when should it ideally be performed?

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Correct answer: B — As soon as possible; glucocorticoids reduce vascular FDG uptake

The best answer is “As soon as possible; glucocorticoids reduce vascular FDG uptake”. When PET-CT is needed for suspected large-vessel GCA it should be obtained promptly because glucocorticoids progressively reduce vascular FDG uptake; urgent treatment must not be delayed to obtain imaging. The remaining choices—“After six months of glucocorticoid treatment, after safety review”, “Principally after inflammatory markers normalise, after specialist assessment”, “After glucocorticoids have been stopped for four weeks”, “Timing is unrelated to glucocorticoid exposure, within a rheumatology pathway”—are credible in related rheumatology presentations, but each addresses a different diagnosis, investigation, treatment sequence or complication and does not fit the decisive findings in this stem.

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