AUTHOR=Wang Dong , Liu Zunjing , Guo Huailian , Yang Li , Zhang Xinhua , Peng Li , Cheng Min , Jiang Hong 

TITLE=Headache attributed to giant cell arteritis complicated with rheumatic polymyalgia diagnosed with F18-fluorodeoxyglucose positron emission tomography and computed tomography: a case report

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1241676

DOI=10.3389/fneur.2023.1241676

ISSN=1664-2295

ABSTRACT=Giant cell arteritis (GCA) is a kind of systemic vasculitis affecting people over 50 years old, and is often the cause of new-onset headache of elder adults. People with GCA is sometimes complicated with rheumatic polymyalgia (PMR). The diagnosis of GCA generally depends on the clinical manifestation, elevated sedimentation rate (ESR) or C-reactive protein (CRP), and positive imaging findings commonly by ultrasound or temporal artery biopsy (TAB). Here we report a case of an 83year-old woman with new-onset headache and elevated ESR. The result of temporal artery ultrasound (TAU) did not distinguish between vasculitis and atherosclerosis. The F18-fluorodeoxyglucose positron emission tomography and computed tomography (18F FDG PET-CT) was performed and suggested large vessel vasculitis with temporal artery involvement. In addition, polyarticular synovitis and bursitis was also revealed. Finally, the diagnosis of secondary headache attributed to CGA complicated with PMR was established. The patient got remission of symptoms after glucocorticoid therapy. PET can become a powerful tool for diagnosis and differential diagnosis when the ultrasound result is ambiguous and biopsy is not obtained.