1. Detailed examination of the temporal artery to detect prominence (Figure 2), nodularity, or tenderness to palpation of the artery and the surrounding skin. In addition, an evaluation of the strength of the temporal artery pulse is crucial.
2. Detailed ophthalmologic examination evaluating visual acuity, pupils (looking for a relative afferent defect), intraocular pressures, anterior segment examination, motility examination (looking for ocular misalignment and/or evidence of cranial neuropathies), and a dilated fundus examination (evaluating for signs of optic nerve or retinal ischemia)
3. Visual fields testing
4. Auscultation of the carotid artery for bruits
5. Auscultation of the heart for an aortic regurgitation murmur to evaluate for aortic aneurysm
At present, prednisone remains the standard of care for GCA. While it works very well, there are many side-effects of this medication. Other immune suppressing medications have been tried but do not work very well for this condition. Methotrexate, a medication commonly used for treatment of rheumatoid arthritis, is sometimes used to help reduce the risk of disease flares. Other treatments are currently being investigated. The types of inflammatory cells that are involved in the arteritis are being identified in current research. Understanding the nature of the inflammatory processes may lead to improved treatment.