Friday, August 15, 2008


A 72 year old man complains of pain and stiffness in his neck, shoulders, and hips. He also gets some pain in his jaw when eating. Speaking of pain, he's noticed a recent new headache. Here's a biopsy:

Challenge: What should this gentleman get before he leaves your office today?

Related Questions:
1. What is the pain in the neck, shoulders, and hips called?
2. What is the feared complication of this disease?
3. What lab test would you like to get?

Images shown under fair use.

1 comment:

Craig said...


Brobdingnagians were giants in Jonathan Swift’s Gulliver’s Travels. This is giant cell arteritis (or temporal arteritis), a chronic vasculitis of large and medium sized vessels. This is suggested by new headache, polymyalgia rheumatica (shoulder, neck, hip pain), and jaw claudication in a person over age 50. It is important to give glucocorticoids today (even before confirmation of the disease) to prevent permanent vision loss. An erythrocyte sedimentation rate will be high.

Sources: UpToDate;; Wikipedia.