29th January 2024

Clinical features

Patients can commonly present with non-specific constitutional symptoms such as fever, weight loss, night sweats, malaise, fatigue, myalgia and arthralgia (mainly of the shoulders and hip joints). 

Other features include those specific to arterial inflammation, such as new onset unilateral or bilateral headache. This is typically over the temples, which can be pulsatile, throbbing or dull in nature. Other symptoms include jaw claudication (jaw pain when chewing) and vision loss, which can present with scintillating scotoma, amaurosis fugax or even permanent loss of vision. Clinical examination may reveal hardened or tender temporal artery. 

Those with large vessel GCA involving the aorta and its primary branches may present with angina pectoris/acute coronary syndrome, abdominal pain or limb claudication. Signs may include asymmetrical pulses and blood pressure readings, vascular bruits, aortic regurgitation murmur and features of aortic aneurysm or dissection. 

Patients with co-existing PMR may present with symptoms of this, such as pain and stiffness of the shoulders or hips with associated limitations on movement.