Carotid tenderness: an ominous sign of giant cell arteritis

Abstract
Giant cell (temporal) arteritis is a systemic vasculitis involving medium and large-sized vessels. Despite the high frequency of involvement of cranial arteries, pain on examination of the external carotid artery itself has been exceptionally reported. We describe 3 patients with biopsy-proven giant cell arteritis (GCA) and wincing pain on palpation over the external carotid. The presence of this sign may be a harbinger of the existence of severe vascular involvement in patients with GCA. Miguel A. González-Gay Division of Rheumatology, Hospital Xeral-Calde, c/Dr. Ochoa s/n, SP-27004 Lugo, Spain

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