The value of a careful history and examination to help diagnose GCA


A new systematic review published in JAMA Internal Medicine assesses which clinical features are more strongly associated with a diagnosis of giant cell arteritis. I like this article as it reaffirms the value of a careful patient history and examination. Jaw claudication (pain on chewing), an abnormal temporal artery examination, and high inflammation markers (CRP, ESR and platelets) came out as key features in favour of GCA.

As expected, none of these was good enough alone to definitively confirm or refute GCA. As such, patients still need to undergo specialised imaging and/or temporal artery biopsy. The combination of the clinical assessment in conjunction with imaging/biopsy result provides the best chance to arrive at the correct diagnosis.

A nice summary is at the limbic.