Giant Cell Arteritis: Navigating Beyond the Headache

Abstract

Giant cell arteritis (GCA) is the most common systemic vasculitis. In the past two decades there have been significant advancements in our understanding of the pathophysiological mechanisms underlying the disease, and consequently the management of GCA is evolving. GCA is a medical emergency because when left untreated it can lead to devastating complications including irreversible visual loss. Thus, prompt diagnosis is imperative to ensure appropriate treatment and prevent ischaemic events. However, uncertainty remains over diagnostic pathways, including appropriate modalities and standardisation of findings. Temporal artery biopsy has been considered the gold standard diagnostic test but has significant limitations in terms of false negative results. In recent times, several new diagnostic modalities have been proposed in GCA including temporal artery ultrasound, CT angiography, magnetic resonance angiography, and PET. In this paper, the authors review the advantages and limitations of current diagnostic modalities in GCA.