Presentation
Headache, scalp tenderness since 20 days with markedly raised C-reactive protein (CRP).
Patient Data
The doppler ultrasound study shows tortuosity with marked hypoechoic, circumferential wall thickening of the superficial temporal arteries bilaterally leading to the classic "halo sign" reaching up to 1.3 millimeters on the right side.
Case Discussion
Clinical presentation and color doppler findings are suggestive of giant cell arteritis.
Giant cell arteritis (a.k.a Horton disease or temporal arteritis) is the most common primary vasculitis in adults. It typically affects people of more than 50 years of age (median age at diagnosis between 70-75 years old).
The vessels most commonly involved are the superficial temporal artery, the ophthalmic artery, the posterior ciliary arteries, and the vertebral arteries, and less commonly, the aorta, coronary arteries, and carotid circulation.
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