Value of MRI in diagnosis of giant cell arteritis

ABSTRACT

Giant-cell arteritis is an infl ammatory disease of blood vessels most commonly involving large and medium arteries of the head, predominately the branches of the external carotid artery. It is a form of vasculitis. Giant-cell arteritis of the temporal artery is referred to as “temporal arteritis”. Giant cell arteritis is rare among Asians. Diagnosis is based on American College of Rheumatology (ACR) classifi cation criteria for giant-cell arteritis with gold standard temporal artery biopsy.1 Blindness is a feared complication, mostly caused by anterior ischaemic optic neuropathy. High-resolution magnetic resonance imaging (MRI) has started to play a role in the diagnosis of giant cell arteritis. Evidence of arteritis involving the superfi cial temporal arteries with mural thickening and even the ophthalmic arteries can be seen on MRI, which further increase the diagnostic confi dence prior to biopsy.2,3 Optic perineuritis is a rare association with giant cell arteritis. MRI is required for diagnosis especially for differentiation from optic neuritis.4 We report a case of giant cell arteritis with optic perineuritis to demonstrate the role of MRI in the diagnosis.