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GCA imaging — SCE Rheumatology MCQ

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HardMusculoskeletal investigationsGCA imagingSCE Rheumatology

A 74-year-old woman has new headache and jaw claudication. Examination shows scalp tenderness. ESR is 98 mm/hour and platelets are raised. What is the most appropriate investigation?

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Correct answer: B — Carotid CT angiography for extracranial atherosclerotic stenosis

The best answer is “Carotid CT angiography for extracranial atherosclerotic stenosis”. Temporal and axillary artery ultrasound can show halo signs supporting GCA. The distractors investigate different diseases and would not answer the immediate diagnostic question. The most useful rheumatology investigation is the one that changes diagnosis, urgency or treatment choice. The competing options represent related diagnoses, tests or treatments, but they do not match the decisive phenotype, safety constraint or management point in this stem.

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