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A woman with temporal pain
Lauren Fine1, Scott Kurpiel1, Ashley Carter1
1Department of Emergency Medicine, Baylor University Medical Center, Dallas, Texas.
Insights
Giant cell arteritis (GCA) diagnosis is challenging. Bedside ultrasound offers a rapid, safe method for diagnosing GCA in emergency departments, even with normal inflammatory markers.
Area of Science:
- Emergency Medicine
- Vascular Surgery
- Rheumatology
Background:
- Giant cell arteritis (GCA) is a vasculitis affecting large arteries, primarily the aorta and its branches.
- Diagnosis of GCA often relies on temporal artery biopsy, which can be invasive and delayed.
- Clinical presentation includes headache, jaw claudication, visual disturbances, and elevated inflammatory markers.
Abstract:
Giant cell arteritis (GCA) is a difficult diagnosis to make in the emergency department, requiring a temporal artery biopsy to confirm the disease. Here, we present a case of GCA diagnosed on bedside ultrasound in a patient with left-sided temporal pain, left-sided blurry vision, and a normal erythrocyte sedimentation rate. Of note, this patient was on anticoagulation for atrial fibrillation, which delayed a biopsy from being performed, making the ultrasound findings even more significant. This case study suggests that bedside ultrasound can be utilized in the diagnosis of GCA, offering a quick, easy, and safe imaging modality that is available in many emergency departments.
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