[MRI-based diagnosis of giant cell arteritis]

Area of Science:

• Rheumatology
• Vascular Medicine
• Diagnostic Imaging

Background:

• Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting large and medium-sized arteries.
• GCA symptoms are often nonspecific and can overlap with polymyalgia rheumatica (PMR), complicating diagnosis.
• Potential complications include ischemia, infarction, and vessel rupture.

Observation:

• A 56-year-old female presented with a year of weight loss, fatigue, and PMR-like symptoms.
• Initial gastroscopy and colonoscopy revealed normal findings.
• Imaging (CT and MRI) demonstrated aortic enlargement and enhancement, raising suspicion for GCA.

Findings:

• The patient's clinical presentation, combined with imaging findings of aortic involvement, suggested GCA.
• Temporal artery biopsy confirmed the diagnosis histologically.
• Prompt medical treatment was initiated upon suspicion.

Implications:

• This case underscores the diagnostic challenge of GCA, especially when initial investigations are unremarkable.
• Advanced imaging modalities are crucial for detecting GCA-related vascular changes, particularly aortic involvement.
• Early diagnosis and treatment of GCA are vital to prevent severe ischemic complications.