Giant cell arteritis — SCE Rheumatology MCQ

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EasyVasculitisGiant cell arteritisSCE Rheumatology

A 74-year-old woman has 2 weeks of new temporal headache, scalp tenderness and jaw claudication. ESR is 92 mm/hour and CRP is 118 mg/L. She has transient blurring of vision in the right eye. Temporal artery is tender and reduced in pulsation. What is the most likely diagnosis?

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Reveal the answer and explanation

Correct answer: E — Giant cell arteritis

Explanation lettering: D = shown as B · E = shown as D · B = shown as E

Giant cell arteritis is best because new cranial headache with jaw claudication, visual symptoms and high inflammatory markers in an older adult is classic GCA. A is less suitable because trigeminal neuralgia causes brief electric facial pain rather than systemic inflammation; C is less suitable because tension headache does not explain high CRP and scalp tenderness; D is less suitable because PMR may coexist but visual symptoms indicate cranial arteritis; E is less suitable because migraine does not cause jaw claudication or tender temporal artery. Clinical pearl: GCA is a same-day treatment diagnosis because visual loss can be irreversible.

Reference: BSR GCA guideline 2020; NICE CKS GCA