Cranial giant cell arteritis mimickers: A masquerade to unveil

Area of Science:

• Rheumatology
• Vascular Medicine
• Diagnostic Imaging

Background:

• Giant cell arteritis (GCA) is a large-vessel vasculitis affecting cranial and extracranial arteries.
• Extracranial GCA often presents with non-specific symptoms, leading to a broad differential diagnosis.
• Cranial GCA has a more typical presentation, but accurate diagnosis remains crucial.

Purpose of the Study:

• To review and present disorders that can mimic cranial GCA.
• To highlight the importance of differential diagnosis in suspected GCA cases.
• To aid clinicians in distinguishing GCA from other conditions with similar presentations.

Main Methods:

• Literature review of conditions mimicking cranial GCA.
• Analysis of diagnostic challenges in differentiating GCA from other diseases.
• Comparison of clinical, ultrasound, and biopsy findings.

Main Results:

• Various conditions, including other vasculitides, hematological disorders, neoplasms, infections, atherosclerosis, and local disorders, can present similarly to cranial GCA.
• These mimic conditions can affect temporal arteries or present with symptoms overlapping with cranial GCA.
• Ultrasound and temporal artery biopsy findings can resemble those of temporal vasculitis in these mimic conditions.

Conclusions:

• Prompt and accurate diagnosis of cranial GCA is essential due to significant variations in treatment.
• Recognizing conditions that masquerade as cranial GCA is critical for appropriate patient management.
• This review provides a comprehensive overview to assist physicians in differential diagnosis.