RCP Medicine Podcast Episode 91: Giant cell arteritis
Sep 27, 2025
Rik Patel, a Consultant rheumatologist and general physician with expertise in large vessel vasculitis, shares insights on giant cell arteritis. He discusses a complex case featuring a 70-year-old patient with headaches and systemic symptoms. Key topics include interpreting headache patterns, the overlap with polymyalgia rheumatica, and the significance of visual symptoms. Rik emphasizes the role of fast-track pathways for diagnosis and treatment, and highlights new treatments like tocilizumab that have transformed patient outcomes.
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Case Presentation With Mixed Symptoms
- A 70-year-old man had six weeks of right temporal/occipital headache, scalp tenderness and systemic features including fever and night sweats.
- He developed proximal stiffness then activity-related biceps cramping and mild morning visual blurring that improved through the day.
Headache Patterns Vary In GCA
- Temporal headache is classic but many GCA patients also have an occipital component, reflecting variable vessel involvement.
- Headache distribution can hint at the type and size of artery involved in GCA.
PMR And GCA Are Closely Linked
- Polymyalgia rheumatica (PMR) and GCA commonly overlap and likely form a disease spectrum.
- About 50% with GCA have PMR symptoms and 10–20% with PMR may develop GCA.