18th January 2024

Clinical presentation

GCA classically presents with the following, either acutely or sub-acutely:

Symptoms

• Temporal headache – usually unilateral but can be bilateral
• Scalp tenderness
• Intermittent claudication to the jaw/tongue – pain on chewing, which resolves on rest
• Constitutional symptoms – fatigue, night sweats, weight loss, anorexia, low-grade fever
• Visual disturbance – flashers/floaters, diplopia, changes in colour vision and in severe cases visual loss
• Features of PMR – proximal muscle pain and stiffness
• Neurological features such as TIA or upper cranial nerve palsies

Signs

• Temporal artery tenderness, thickening, nodularity or ulceration
• Pallor and oedema of the optic disc on fundoscopy