Featuring Dr. John Wade, MD, FRCPC, Rheumatologist

Duration: 4 minutes, 2 seconds

Giant cell arteritis is a relatively uncommon but very important medical condition that we see in people over the age of 50. Typically seen in people in their 70s and 80s, although we do recognize it - see it sometimes in people that are a bit younger.

This disease is an inflammation of the vessels. It’s an inflammation of the large vessels. We break down vessels in the body into large, medium and small vessels, and giant cell arteritis is a disease of the large vessels.

Typically the vessels that are involved are the vessels that go from around the heart into the head and into the arms. So if you’re having symptoms, they’ll be symptoms in those areas. The symptoms of giant cell arteritis can be quite subtle.

Common symptoms of that are fatigue, weight loss, just feeling unwell overall, aches and pains. And about two thirds, if not more people with giant cell arteritis will have significant aches and pains in the shoulder girdle and the pelvic girdle area, but there are some cardinal symptoms that we always think of when we think of giant cell arteritis.

Typically, it presents as a temporal-type headache, or temporal on the side of the head here. Sometimes, actually, it’s called temporal arteritis, or inflammation of the temporal artery. In addition to a headache, which is one of the more common features, you can also have symptoms of jaw claudication.

So jaw claudication is when you’re chewing, and you’re eating. After you’re eating for a minute or two, you get pain or discomfort in the muscles of the jaw. So it’s not the pain in the jaw itself, it’s in the muscles of the jaw, or jaw claudication.

A third, fortunately quite rare but devastating complication is going to affect the artery going to the eye. And that can result in visual loss, so it may be partial or complete visual loss in one eye. Visual loss occurs in about 10 percent of people that have this disease in one eye, or in one oculus visual loss.

The real absolute devastation, fortunately you see it only rarely, if they lose vision in one eye, to lose vision in the other eye. So now you have someone that’s blind. And that’s why it’s extremely important to recognize this condition, recognize that people if they’ve had visual loss in one eye, they’re the ones that are at increased risk of going blind in the second eye. So it’s very important to treat this disease early, when you recognize it, and aggressively.

Patients that present with a condition called polymyalgia rheumatica, or PMR – easier to say than polymyalgia rheumatica – about one third of those patients may go on to develop giant cell arteritis. So patients that present with acute or severe pain in the neck, shoulders, hip girdle, you need to have an index of suspicion that they may go on and develop giant cell arteritis.

So those patients you need to be very careful about asking these questions about headaches, jaw claudication, visual complaints and other symptoms that you see with giant cell arteritis. If you have any questions or concerns about the symptoms of giant cell arteritis, you should speak to your healthcare provider or your specialist.

Presenter: Dr. John Wade, Rheumatologist, Vancouver, BC

Local Practitioners: Rheumatologist