26th February 2025

A 77-year-old female is referred urgently to rheumatology clinic from her general practitioner.

A 77-year-old female is referred urgently to rheumatology clinic from her general practitioner. She has had a history of headache, which started around 4 weeks ago. On specific questioning, she admits she has noted some pain in her jaw when eating. She denies any visual loss. 

She has felt increasingly fatigued over the last few weeks, and it has taken her some time to get going in the morning. She describes pain in her hips bilaterally and has been struggling to do her hair in the morning due to pain in her upper arms.

She has a past medical history of migraines, bowel cancer, which was surgically treated in 2003, and hypertension.

On examination she struggles to lift her arms above her head. Power is 5/5 throughout the upper and lower limbs. She has tenderness over the right temporal artery, and there is no palpable pulse. 

He has blood tests performed, which show:

nt-weight: 400;”>US temporal artery revealed no abnormality.

Temporal artery biopsy was completed, and histology showed normal appearances.

What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.