MSK: Temporal Arteritis: Free MSRA Podcast

🎙️ Deep Dive: Temporal Arteritis (Giant Cell Arteritis)🚨 A must-know ophthalmic and MSK emergency – vital for MSRA revision!Welcome back to the Deep Dive – your high-yield, no-fluff guide to essential exam topics. Today, we’re tackling Temporal Arteritis, also called Giant Cell Arteritis (GCA) – a dangerous vasculitis affecting older adults, with sight-threatening potential. Let’s break it down clearly and concisely.🧠 Key Points Covered📌 Definition• Chronic immune-mediated large vessel vasculitis• Affects temporal arteries and other cranial branches of the carotid artery• Can lead to irreversible vision loss – an ophthalmological emergency!📌 Causes & Risk Factors• Exact cause unknown – autoimmune with genetic predisposition (e.g. HLA-DRB1)• Age >50, female, northern European ancestry• Often associated with polymyalgia rheumatica (PMR)🧠 Mnemonic: T = Time-sensitive (vision at risk!)📌 Symptoms• New-onset temporal headache, scalp tenderness• Jaw claudication – pain when chewing• Visual symptoms: blurring, diplopia, sudden blindness• Systemic signs: weight loss, fatigue, fever, PMR symptoms🧠 Mnemonic: 5 Ts + J-V-S-P– Temporal headache, Tender artery, Thickened artery, Teeth pain, Tiredness– Jaw claudication, Visual changes, Scalp pain, PMR📌 Differential Diagnoses• Takayasu arteritis, Polyarteritis nodosa• GCA mimics: stroke, migraine, optic neuritis• Vasculitis from infection (e.g. syphilis)📌 Investigations• ESR & CRP: usually high – but ESR can be <30 in 10%• FBC: anaemia, thrombocytosis• Autoantibodies: usually normal• Temporal artery biopsy: gold standard (beware of skip lesions)• Ultrasound (halo sign) or PET scan for large vessel involvement🧠 Important: Do not delay steroids for biopsy!📌 Management• Start high-dose corticosteroids immediately– No visual loss: prednisolone 40–60 mg– Visual loss: IV methylprednisolone followed by high-dose oral• Bone protection: bisphosphonates, calcium, vitamin D• Steroid-sparing agents: methotrexate, tocilizumab (IL-6 blocker)• Monitor: CRP, ESR (except with tocilizumab), BP, glucose, eyes• Ophthalmology referral essential if vision affected🧠 Steroid taper: slow reduction over months/years📌 Complications• Permanent vision loss (15–20%)• Aortic aneurysm/dissection• Long-term steroid side effects: osteoporosis, diabetes, hypertension• Relapse is common – needs long-term follow-up📌 Prognosis• Good if treated early• Vision loss often irreversible if steroids delayed• Long-term steroids often needed; relapse risk 50%📚 High-Yield MSRA Resources📝 Revision Noteshttps://www.passthemsra.com/topic/temporal-arteritis-revision-notes-2/🧠 Flashcardshttps://www.passthemsra.com/topic/temporal-arteritis-flashcards/💬 Accordion Q&A Noteshttps://www.passthemsra.com/topic/temporal-arteritis-accordion-qa-notes-2/🧪 Rapid Quizhttps://www.passthemsra.com/topic/temporal-arteritis-rapid-quiz/🧠 Full Quizhttps://www.passthemsra.com/quizzes/temporal-arteritis/💡 MSK Coursehttps://www.passthemsra.com/courses/msk-for-the-msra/🩺 Key Takeaway:In any patient over 50 with a new headache or visual change, think GCA. Treat fast to save sight. ESR/CRP may be normal – trust your clinical judgment. Steroids first. Biopsy second. Always protect against steroid complications.For more, visit:🌐 https://www.passthemsra.com🌐 https://www.freemsra.com#MSRA #TemporalArteritis #GCA #VisionLoss #Ophthalmology #MSK #MSRAQuiz #MSRAFlashcards #MSRARevision #PolymyalgiaRheumatica #MedicalPodcast #DeepDiveMSRA