Giant cell arteritis of the distal superficial femoral artery

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Known giant cell arteritis with painful left temple. On prednisolone. Now developing right leg claudication.

Patient Data

Age: 60 years
Gender: Male

Right lower limb arteries

ultrasound

Findings similar to that seen in the superficial temporal artery with circumferential hypoechoic wall thickening (halo) and increased flow velocities in the distal superficial femoral artery. Proximal and distal arteries are essentially normal.

Lt superficial temporal artery

ultrasound

Typical pattern of circumferential hypoechoic wall thickening involving the painful left superficial temporal artery.

Case Discussion

Although giant cell arteritis (GCA) typically involves the extra-cranial arteries especially the superficial temporal, it can involve intracranial arteries especially the retinal as well as larger arteries including the aorta and its branches. The typical ultrasonic appearance is a cuff of hypoechoic tissue causing smooth luminal narrowing and increased flow velocities on duplex imaging.

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