Temporal Arteritis See Polymyalgia Rheumatica

The primary manifestation of temporal arteritis is headache, although the major complication is acute, often irreversible visual loss. Polymyalgia rheumatica is the systemic form of temporal arteritis and has evolved separate diagnostic criteria, which are presented separately. Pathologically, biopsy of extracranial arteries (e.g., temporal artery) shows three major findings: granulomas with giant cells, often near remnants of the internal elastic membrane; nonspecific neutrophilic, eosinophilic, and lymphocytic infiltration of blood vessel wall; intimal fibrosis.

Temporal arteritis is among the most common of the vasculitides, with a strong age-related incidence. Several epidemiological studies have found that it may be becoming more common, although there is likely a strong secular trend because of better diagnostic awareness. There are differences in incidence between ethnic groups. It appears to be very rare in Asians, and relatively rare in Hispanic and African-American populations. In a retrospective study from the Mayo Clinic, the age- and gender-adjusted incidence was 18 per 100,000 per year over age 50. Incidence in women was 24 per 100,000 per year, and was 12 per 100,000 per year in men. Diagnostic criteria appearing Table 13.

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