A 57-year-old woman is complaining of frequent headaches and scalp tenderness. She also has arthralgias, fatigue, and discomfort in her jaw when she chews. On examination, her head and neck is normal, but the right temporal artery is tender on palpation. Her erythrocyte sedimentation rate (ESR) is 50 mm/h and hemoglobin 10.5 g/dL. A temporal artery biopsy is obtained for diagnostic confirmation. Which of the following is the most appropriate next step in management?
High-Yield Explanation
The response of pain, stiffness, and headaches to 40-60 mg of prednisone is dramatic in giant cell arteritis. The duration of treatment is not known but most patients require treatment for more than 2 years. ESR is used to monitor response to therapy. Patients need treatment and evaluation for the complications of long-term steroid use such as osteoporosis and diabetes.