skip to main content

Giant cell arteritis with diplopia — SCE Rheumatology MCQ

Instant feedback + full explanation. One question, done properly.

HardVasculitisGiant cell arteritis with diplopiaSCE Rheumatology

A 72-year-old woman with PMR is on prednisolone 12.5 mg daily. She reports new diplopia and scalp tenderness but no jaw pain. ESR is 34 mm/hour, CRP is 12 mg/L and she received methylprednisolone for a COPD exacerbation last week. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: E — Treat as suspected GCA despite modest inflammatory markers

Diplopia and scalp tenderness in a patient with PMR should prompt urgent treatment for possible GCA, even if inflammatory markers are modest after recent steroids. Visual symptoms make this time-critical. Steroid-sparing PMR treatment does not address imminent ischaemic risk.

Reference: BSR giant cell arteritis guideline; EULAR large-vessel vasculitis recommendations