A case of giant cell arteritis and polymyalgia rheumatica misdiagnosed as temporomandibular dysfunction. Issue 2 (24th March 2018)

• Record Type: Journal Article
• Authors: Nys, Margaux; Van der Cruyssen, Fráderic; David, Karel; Politis, Constantinus
• Is Part Of: Oral science international. Volume 15:Issue 2(2018)
• Page Start: 81
• Page End: 85
• Publication Date: 2018-03-24
• Subjects: TMJ dysfunction -- Giant cell arteritis -- Scalp necrosis; Oral medicine -- Periodicals; Mouth -- Diseases -- Periodicals; Mouth -- Diseases; Oral medicine; Oral Medicine -- Periodicals; Stomatognathic Diseases -- Periodicals; Periodicals; 617.522
• DOI: 10.1016/S1348-8643(18)30006-5
• Languages: English
• ISSNs: 1348-8643

Abstract

Abstract: We report the case of a 83‐year‐old man who presented with bilateral scalp ulcerations, temporomandibular joint pain, anorexia, and generalized discomfort. The aspecific presentation and timing of the symptoms led to a referral delay of 117 days. A temporal artery biopsy confirmed the diagnosis of giant cell arteritis (GCA). FDG‐PET showed increased uptake at the large vessels, shoulders, and hips, suggesting concomitant polymyalgia rheumatica. Initiation of methylprednisolone resulted in resolution of the muscle‐related complaints and healing of the ulcerations. This report highlights the importance of prompt diagnosis and the rarity of bilateral scalp necrosis in GCA, with an incidence of <5%.