Jaw tightness in proximal temporal arteries. Diagnosis-

Ans. is 'c' i.e., Giant cell arteritis o Giant cell or temporal arteritis, the most common form of systemic vasculitis affecting the adults, is an acute and chronic, often granulomatous inflammation of arteries of large to small size.o This vasculitis affects principally the arteries in the head. the extracranial branches of carotid artery especially the temporal arteries. It can also affect the vertebral ophthalmic arteries and the aorta where it may cause thoracic aneurysm.o Ophthalmic artery involvement can lead to sudden blindnessQ which is the most feared complication of temporal arteritis.o Polymyalgia rheumaticaQ is an aching and stiffness of the shoulder, neck and hip girdle area that can occur with giant cell arteritis or more commonly by itselfThe classic presenting manifestation of giant cell arteritis areo HeadacheQ (70%)o Jaw claudicationQ (50%)o Constitutional symptomsQ (50%)o Polymylagia rheumaticaQ (40%)o Usual lossQ (20%)o Abnormal temporal artery Q (50%)o AnemiaQ (80%)o ESR > 50 mm/lQ (Wo)o ArthritisQ (15%)The laboratory hallmarks of giant cell arteritis are:o Markedly elevated ESRo AnemiaQo The classical symptoms of GCA include headache, jaw claudicationr polymyalgia rheumatica, visual symptoms and malaise. The onset may be gradual or sudden.Three of the following criteria must be met to diagnose Giant cell arteritisAge >50 yearsQNew headacheQAbnormal temporal arteryQESR >50 mm/hQPositive temporal ariety biopsy results for vasculitis which shows granulomatous inflammation(r) with the presence of multinucleate giant cells of both foreign body and langhanc type.