Pre PACES Podcast #81 Giant cell arteritis
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Feb 18, 2024 Dr. Matt Wells, a Rheumatology registrar, dives deep into the complexities of giant cell arteritis (GCA). He shares his insights on common clinical presentations, age-related diagnostic considerations, and the significance of scalp tenderness. The conversation highlights essential investigations like ultrasound and temporal artery biopsy, alongside acute management strategies involving steroids. Matt also discusses risk factors, potential relapses, and cutting-edge treatments. Plus, he rounds off the chat with a fun quiz on giants in popular culture!
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Large-Vessel GCA Can Be Systemic
- GCA includes cranial and extracranial large-vessel phenotypes; extracranial disease may present with systemic symptoms and aortic involvement.
- PET-CT can show aortic FDG uptake in 10–50% of cranial GCA patients, with uncertain clinical significance.
PMR And GCA Association
- About 10–20% of patients with polymyalgia rheumatica will develop giant cell arteritis.
- Counsel newly diagnosed PMR patients to seek prompt review if they develop headache or visual symptoms.
Notable Familial Risk
- A positive family history confers a substantially increased risk; having an affected sibling raises risk roughly tenfold.
- Family history is relevant though rarely a high-scoring PACES point.
