Fact-sheet: Temporal arterite
Updated on 10/07/2017 at 7:46 AM
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Definition
Granulomatous vasculitis affecting large-caliber arteries (aorta, supra-aortic trunks, branches of the external carotid artery).
Clinical features
Only after age 50. Female predominance (2F/1M). Signs related to the topography of the affected arteries: - headaches - scalp hyperesthesia - jaw claudication - acute anterior ischemic optic neuritis Frequently associated with polymyalgia rheumatica (inflammatory girdle pain).
Laboratory findings
Biological inflammatory syndrome (elevated ESR, CRP, fibrinogen).
Ultrasound
Hypoechoic halo around the superficial temporal arteries.
Wall thickening of the supra-aortic trunks
CT
Aorta +++:
--> Regular circumferential thickening of the aortic wall (no consensus threshold thickness: 2 or 3 mm), wall enhancement on the portal phase after contrast injection.
All large-caliber arteries can be affected, notably the supra-aortic trunks.
MRI
Aorta, temporal arteries:
--> thickened and inflammatory walls on T2 FatSat or STIR, enhancing with gadolinium.
Nuclear medicine
PET:
--> hypermetabolism of the affected arteries (aorta and supra-aortic trunks +++)
Management
Prolonged corticosteroid therapy
Differential diagnosis
Atherosclerotic lesions
Other causes of aortitis (Takayasu arteritis)