Transient ischemic attacks or cerebral infarctions, most often in the territory of the vertebral artery, are uncommon. These are the non-specific symptoms of inflammatory or infectious diseases or malignancies and consist of malaise, anorexia, weight loss, fever, night sweats, and depressed mood. These symptoms are those of polymyalgia rheumatica, which are present in about half of patients with giant-cell arteritis. They are intense pain and stiffness in the neck, and proximal muscles of the upper and lower limbs. The stiffness and pain are worsened by rest, so much so as to make getting out of bed in the morning extremely difficult.
Muscle weakness is absent.
The main finding, present in a majority of the patients, is swollen, nodular, tender temporal arteries often with diminished pulsations. When visual loss has occurred, the optic disk is pale and swollen. It should be done in all patients suspected to have giant-cell arteritis, not only for its confirmatory value, but to establish a baseline level by which to judge the effects of therapy. An elevated ESR does not, however, establish the diagnosis of giant-cell arteritis, since elevations are not specific for this disease. A temporal-artery biopsy can establish the diagnosis by showing the characteristic histology of the disease.