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Giant cell arteritis — SCE Rheumatology MCQ

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HardMusculoskeletal investigationsGiant cell arteritisSCE Rheumatology

A 72-year-old woman has a new temporal headache, scalp tenderness, jaw claudication and ESR 96 mm/hour. Glucocorticoid treatment is started immediately. Which investigation should be arranged promptly to support the suspected diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Temporal artery ultrasound, within a rheumatology pathway

The best answer is “Temporal artery ultrasound, within a rheumatology pathway”. In a patient older than 50 with a high clinical probability of giant cell arteritis, temporal artery ultrasound is an appropriate rapid confirmatory test and treatment must not be delayed for imaging. The remaining choices—“Carotid CT angiography, after safety review, within a rheumatology pathway”, “Brain MRI with diffusion imaging, after safety review”, “Lumbar puncture with opening pressure, after specialist assessment”, “Electroencephalography, within a rheumatology pathway, with clinical reassessment”—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