Pre PACES Podcast #81 Giant cell arteritis
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Feb 18, 2024 Dr. Matt Wells, a Rheumatology registrar, dives deep into the complexities of giant cell arteritis (GCA). He shares his insights on common clinical presentations, age-related diagnostic considerations, and the significance of scalp tenderness. The conversation highlights essential investigations like ultrasound and temporal artery biopsy, alongside acute management strategies involving steroids. Matt also discusses risk factors, potential relapses, and cutting-edge treatments. Plus, he rounds off the chat with a fun quiz on giants in popular culture!
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Key Red Flags To Ask First
- Ask about new unilateral subacute headache, jaw claudication, visual symptoms and temporal scalp tenderness immediately.
- Prioritise age >50 and seek same-day review for any visual change or jaw claudication.
Age Strongly Favors Or Against GCA
- Age is highly discriminatory: classification criteria require age ≥50 and typical cases occur in the 70–80s.
- Finding GCA in patients under 60 is uncommon and in the 40s is usually unlikely.
Probe Jaw Claudication And Vision
- Specifically ask about jaw or tongue claudication with talking/chewing and any monocular visual loss or diplopia.
- Treat visual symptoms as an ophthalmic emergency requiring same-day review.
