Giant cell arteritis — SCE Rheumatology MCQ

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ModerateVasculitisGiant cell arteritisSCE Rheumatology

A 69-year-old man has new temporal headache, scalp tenderness and jaw claudication. Examination shows the temporal artery is tender and pulsation is reduced. Investigations show ESR is 96 mm/hour with thrombocytosis. The admitting team asks which diagnosis best explains the whole presentation. What is the most likely diagnosis?

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Correct answer: B — Giant cell arteritis

Giant cell arteritis is the best answer because the pattern described is most consistent with Giant cell arteritis, including the distribution of symptoms and the targeted investigation results. Osteoarthritis is a plausible distractor, but it does not account for the key discriminator in the stem. CPP crystal arthritis and Microscopic polyangiitis would be more appropriate in a different clinical pattern or at another point in the pathway, while Polymyalgia rheumatica is suboptimal for this presentation. Clinical pearl: in SCE-style questions, the decisive clue is usually the pattern across joints, extra-articular features and targeted immunology rather than a single antibody result.

Reference: BSR GCA guideline; EULAR ANCA-associated vasculitis recommendations; BNF