Giant cell arteritis

Case contributed by Dr Enrico Citarella


Temporal region bilateral pain. Visual impairment. Raised serum erythrocyte sedimentation rate (ESR) and serum C reactive protein (CRP). Follow up after steroid therapy.

Patient Data

Age: 74
Gender: Female

Baseline ultrasound study

Bilateral diffuse thickening of the temporal arterial wall which appears hypoechoic. The vessel course is quite tortuous.


Follow up ultrasound study 40 days later after steroid therapy.

Lesser evidence of the temporal arterial wall which is also less hypoechoic. Vessel's course is still quite tortuous.

PW exam shows a normal flow with well represented diastolic component.

Case Discussion

After steroid therapy (prednisone 50 mg/die) follow up study shows a substantial reduction of the arterial wall thickening and hypoechogenicity due to flogosis.

Serum erythrocyte sedimentation rate (ESR) and serum C reactive protein (CRP) lowered into normal ranges. Symptoms (temporal pain and visual impairment) reduced too.

Unfortunately biopsy was not performed, so diagnosis is to be considered presumptive.

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Case information

rID: 35675
Case created: 15th Apr 2015
Last edited: 9th Sep 2015
System: Vascular
Inclusion in quiz mode: Excluded

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