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Tests and diagnosis
By Mayo Clinic staffGiant cell arteritis can be difficult to diagnose because its early symptoms resemble those of many common conditions. For this reason, your doctor will try to rule out other possible causes of your problem.
To help diagnose giant cell arteritis, you may have some or all of the following tests:
- Physical exam. In addition to asking about your symptoms and past medical history, your doctor is likely to perform a thorough physical exam, paying particular attention to your temporal arteries. Often, one or both of these arteries are tender, with a reduced pulse and a hard, cord-like feel and appearance.
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Blood tests. If your doctor suspects giant cell arteritis, you're likely to have a blood test that checks your erythrocyte sedimentation rate — commonly referred to as the sed rate.
This test measures how quickly red blood cells fall to the bottom of a tube of blood. Red cells that drop rapidly may indicate inflammation in your body. You may also have a test that measures C-reactive protein (CRP), a substance your liver produces when inflammation is present. The same tests may be used to follow your progress during treatment.
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Biopsy. Although blood tests and blood vessel imaging tests, such as MRI angiography and cerebral angiography, can provide your doctor with useful information, the only way to confirm a diagnosis of GCA is by taking a small sample (biopsy) of the temporal artery. Because the inflammation may not occur in all parts of the artery, more than one sample may be needed.
The procedure is performed on an outpatient basis under local anesthesia, usually with little discomfort or scarring. The sample is examined under a microscope in a laboratory. If you have GCA, the artery will often show inflammation that includes abnormally large cells, called giant cells, which give the disease its name.
Unfortunately, a biopsy isn't foolproof. It's possible to have GCA and still have a negative biopsy result. If the results aren't clear, your doctor may advise a biopsy on the other side of your head.
