Abstract
Giant Cell Arteritis (GCA) is the most common form of vasculitis in the adult population. It classically presents with new-onset headache in a patient older than 50 years, and reflects predominantly-intracranial vessel pathology. We describe a 67-year old man who presented with subacute myalgia of the lower extremities and constitutional symptoms, and was later found to have an extra-cephalic presentation of GCA. Magnetic Resonance Imaging of the lower extremities demonstrated diffusely enhanced signal intensity in the distribution of the quadriceps muscle, initially leading us to suspect an inflammatory myopathy. Muscle biopsy under radiographic guidance, however, was normal. Confronted with a middle-aged gentleman with non-specific symptoms and elevated laboratory markers of systemic inflammation, we performed a biopsy of the temporal artery and nailed the atypical, ‘silent’ form of GCA. The patient responded favorably to treatment with prednisone
Citation
Oren O, Jacob G, Oren M, Aloush V and Ablin JN. Vasculitis Presenting with Lower Extremity Myalgia. SM J Case Rep. 2016; 2(3): 1029.