Differential Diagnosis for Temporal Arteritis
Single Most Likely Diagnosis
- Giant Cell Arteritis (GCA): This is the most likely diagnosis given the presentation of temporal arteritis. GCA is a large vessel vasculitis that commonly affects the temporal artery, leading to symptoms such as headache, scalp tenderness, jaw claudication, and visual disturbances.
Other Likely Diagnoses
- Polymyalgia Rheumatica (PMR): Often associated with GCA, PMR presents with muscle pain and stiffness, particularly in the shoulders and hips, and can be a related condition rather than a distinct differential diagnosis.
- Temporal Artery Aneurysm or Pseudoaneurysm: Although less common, aneurysms or pseudoaneurysms of the temporal artery can mimic some symptoms of temporal arteritis, such as a palpable mass or localized pain.
- Temporal Cellulitis or Abscess: Infections in the temporal region can cause pain, swelling, and redness, which might be confused with the inflammatory signs of temporal arteritis.
Do Not Miss Diagnoses
- Aortic Dissection or Aneurysm: While not directly related to temporal arteritis, GCA can be associated with aortic aneurysms or dissections. Missing this diagnosis could be catastrophic.
- Stroke or Transient Ischemic Attack (TIA): Visual disturbances or other neurological symptoms in temporal arteritis could also indicate a stroke or TIA, which require immediate medical attention.
- Cancer (e.g., Temporal Bone Tumors): Although rare, tumors in the temporal region can cause similar symptoms to temporal arteritis and must not be overlooked.
Rare Diagnoses
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis, GPA): A form of vasculitis that can affect various parts of the body, including the temporal artery, though it is much less common than GCA.
- Takayasu Arteritis: A large vessel vasculitis that primarily affects the aorta and its major branches, which can sometimes involve the temporal artery.
- Kawasaki Disease: Typically affects children and involves inflammation of blood vessels throughout the body, which could potentially involve the temporal artery, though it's exceedingly rare in adults.