The tortuous, prominent temporal artery is seen over the forehead, and microscopically there is a giant cell arteritis. The typical pattern of involvement with temporal arteritis includes the temporal artery and branches of external carotid arteries. A sixth of cases may have involvement of aorta and its major branches. Involvement of the ophthalmic branch of the external carotid can lead to blindness. The prevalence of giant cell arteritis increases with age. Signs and symptoms can include headache and a painful, palpably enlarged and tender temporal artery. Some persons will also have polymyalgia rheumatica. There are no specific laboratory findings, though the sedimentation rate is often quite elevated (as high as 100 mm/hr or more). A trial of corticosteroid therapy, if succesful, may provide a presumptive diagnosis in lieu of biopsy.
| Our winner is: Brian C. Grubbs, MD of St. Paul, Minnestota, USA
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