Unfortunately other conditions such as infections can also cause an ESR rise and so diagnosis is not solely made on the basis of the ESR result. The gold standard for diagnosis is a biopsy of the temporal artery. The inflammation in the blood vessels is not uniformly present and sections of the blood vessels can still be normal. Hence, a positive biopsy showing inflammation confirms disease but a negative biopsy does not exclude disease. The aim of treatment is to relieve the patient of troublesome symptoms and prevent ischaemic symptoms due to lack of oxygen.
Most symptoms resolve with treatment.
High dose oral steroids in the form of prednisolone is usually given and the dose is tapered over months, using the ESR marker as a guide to response. Treatment with steroids is given for at least 1-2 years. Steroids work by suppressing inflammation, but also suppresses the body's ability to fight infection. Steroids will accelerate the natural process of bone thinning, and fractures can occur. Steroids can also cause or aggravate indigestion, sugar diabetes, high blood pressure, thinning and bruising of the skin and weight gain.