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Giant cell arteritis — SCE Rheumatology MCQ

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HardVasculitisGiant cell arteritisSCE Rheumatology

A patient with giant cell arteritis and baseline aortitis is in sustained clinical and biochemical remission. What is the best imaging follow-up principle?

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

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Correct answer: C — Clinical follow-up with selective angiographic surveillance of structural damage

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

E is correct. EULAR does not recommend routine imaging for activity in clinical and biochemical remission because persistent abnormalities may not represent actionable disease. MRA, CTA or ultrasound can be individualised for long-term structural surveillance, particularly at previously inflamed sites or when aneurysm or stenosis is suspected. Serial PET exposure and imaging-driven immunosuppression without clinical context are unsupported.

Reference: 2023 EULAR imaging recommendations for large-vessel vasculitis. https://ard.bmj.com/content/83/6/741