Key clinical features raising suspicion for temporal arteritis (giant cell arteritis) in patients over 50 years include:
- New onset localized headache, often temporal, which may be severe and persistent.
- Scalp tenderness, especially over the temporal artery.
- Jaw claudication—pain or fatigue in the jaw muscles on chewing.
- Visual symptoms such as transient or permanent visual loss, diplopia (double vision), or visual field defects.
- Constitutional symptoms including unexplained fever, weight loss, and fatigue.
- Symptoms of polymyalgia rheumatica such as proximal muscle stiffness and pain.
- Physical signs such as a thickened, tender, or pulseless temporal artery on examination.
Laboratory findings supporting suspicion include elevated inflammatory markers: raised erythrocyte sedimentation rate (ESR) often >50 mm/hour, elevated C-reactive protein (CRP), normochromic normocytic anemia, and thrombocytosis, although normal ESR does not exclude the diagnosis.
Because temporal arteritis is a medical emergency due to the risk of irreversible vision loss, any new visual symptoms or jaw claudication in a patient over 50 should prompt urgent specialist referral and initiation of high-dose glucocorticoids without delay.
These clinical features are consistent with UK guidelines emphasizing the importance of early recognition and treatment to prevent serious complications NICE CKS. The literature similarly highlights these symptoms as key diagnostic clues, noting that headache and jaw claudication are among the most specific clinical features Smetana & Shmerling 2002.