Giant cell aortitis

Case contributed by Dr Chris O'Donnell

Presentation

Generally unwell with fevers and loss of weight. Very high inflammatory markers ? occult malignancy

Patient Data

Age: 65
Gender: Female
Nuclear medicine

Generalized circumferential accumulation of FDG in the walls of the aorta, subclavian, carotid, femoral and popliteal arteries.

CT

Widespread circumferential aortic wall thickening without calcification as might be expected if the findings were due to atherosclerosis. Diagnosis confirmed on temporal artery biopsy.

Case Discussion

Giant cell arteritis normally affects the superficial temporal arteries, but can involve other extracranial branches including the retinal arteries leading to blindness. Larger arteries including the aorta are less commonly affected. FDG accumulation reflects inflammation in the arterial wall - i.e. increased glucose metabolism by neutrophils and lymphocytes.

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