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Giant cell arteritis — RCPSC IM MCQ

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HardRheumatologyGiant cell arteritisRCPSC IM

A 69-year-old has new headache, scalp tenderness, jaw claudication, ESR 86 mm/h and two episodes of transient monocular visual loss. Giant-cell arteritis is strongly suspected. What is the most appropriate immediate management?

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Correct answer: A — Start high-dose glucocorticoids now; arrange urgent diagnostic assessment

The best answer is “Start high-dose glucocorticoids now; arrange urgent diagnostic assessment”. Ischemic visual symptoms make suspected giant-cell arteritis a treatment emergency because delay risks irreversible blindness. Diagnostic imaging or biopsy should be arranged urgently but must not postpone glucocorticoids; low-dose therapy, NSAIDs or methotrexate alone are inadequate.

Reference: Canadian Rheumatology Association, clinical guidelines and position statements: https://rheum.ca/resources/publications/