SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences

Information for Patients

View all Images (10)

Emergency: requires immediate attention
Giant cell arteritis
Other Resources UpToDate PubMed
Emergency: requires immediate attention

Giant cell arteritis

Contributors: Michael W. Winter MD, Ryan Hoefen MD, PhD, Susan Burgin MD, Paritosh Prasad MD
Other Resources UpToDate PubMed


Giant cell arteritis (GCA) is a systemic vasculitis affecting medium- to large-sized arteries, including the aorta and the extracranial branches of the carotid artery. GCA is rarely found in individuals younger than 55, and the mean age for disease presentation is 76.

Patients may present with systemic symptoms such as a new temporal headache, fever, anorexia, weight loss, morning stiffness in the shoulder or neck, myalgia, fatigue, and anemia. There may be elevated ESR or C-reactive protein, temporal artery tenderness to palpation, or decreased arterial pulsation unrelated to arteriosclerosis. Patients may have scalp tenderness, visual disturbances (amaurosis fugax), jaw or tongue claudication or difficulty chewing, or upper cranial palsies.

GCA and polymyalgia rheumatica (PMR) have a significant clinical association: 16%-21% of cases of PMR are associated with GCA, and 40%-60% of patients diagnosed with GCA also have PMR.

The most serious complication of GCA is sudden blindness, a result of anterior ischemic optic neuropathy caused by ischemia secondary to inflammation of the ophthalmic artery supplying the optic nerve. Some patients may experience transient vision loss. All patients with suspected GCA should have temporal artery biopsy. Pathologic findings include a predominance of mononuclear cell infiltration or granulomatous inflammation, usually with multinucleated giant cells.

Scalp necrosis is a rare but potentially life-threatening complication.

The 2022 American College of Rheumatology (ACR) / European Alliance of Associations for Rheumatology (EULAR) classification criteria for GCA when a diagnosis of medium-vessel or large-vessel vasculitis has been made:

A patient aged 50 years or older; 6 or more of the following points are needed for diagnosis:

Clinical criteria
  • Morning stiffness in the shoulders or neck, jaw or tongue claudication, new temporal headache, scalp tenderness, abnormal clinical examination of the temporal artery (such as diminished pulse, tenderness, or a hard, cord-like texture) (+2 each)
  • Sudden visual loss (+3)
Laboratory, imaging, and biopsy criteria
  • ESR ≥ 50 mm/hour or C-reactive protein ≥ 10 mg/L (+3)
  • Positive temporal artery biopsy or temporal artery halo sign on ultrasound (+5)
  • Bilateral axillary luminal damage (as seen on angiography, ultrasound, or fluorodeoxyglucose-positron emission tomography [FDG-PET]; +2)
  • FDG-PET uptake throughout the aorta (+2)


M31.6 – Other giant cell arteritis

400130008 – Temporal arteritis

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

To perform a comparison, select diagnoses from the classic differential

Subscription Required

Best Tests

Subscription Required

Management Pearls

Subscription Required


Subscription Required

Drug Reaction Data

Subscription Required


Subscription Required

Last Reviewed:01/23/2023
Last Updated:02/08/2023
Copyright © 2024 VisualDx®. All rights reserved.
Emergency: requires immediate attention
Patient Information for Giant cell arteritis
Print E-Mail Images (10)
Contributors: Medical staff writer
Premium Feature
VisualDx Patient Handouts
Available in the Elite package
  • Improve treatment compliance
  • Reduce after-hours questions
  • Increase patient engagement and satisfaction
  • Written in clear, easy-to-understand language. No confusing jargon.
  • Available in English and Spanish
  • Print out or email directly to your patient
Copyright © 2024 VisualDx®. All rights reserved.
Emergency: requires immediate attention
Giant cell arteritis
A medical illustration showing key findings of Giant cell arteritis
Copyright © 2024 VisualDx®. All rights reserved.