2018 Volume 30 Issue 2 Pages 135-140
[Patient] a 70-year-old man [Chief complaints] fever, headache, cervicodynia [Clinical history] A 70-year-old man presented to hospital with two months of fever, headache and cervicodynia. Giant cell arteritis (GCA) was strongly doubted due to temporal artery tenderness, advanced age, a new-onset headache and increased erythrocyte sedimentation rate. However FDG-PET CT is known to be useful for the diagnosis of GCA, it did not show any abnormal uptake in the vascular walls in this case. The contrast-enhanced MRI revealed lateral enhancement of the branches of superficial temporal artery without stenosis in the T1-weighted fat suppression images, which is consistent with GCA. The patient was started on daily high-dose prednisone (1mg/kg/day) , and clinical and laboratory findings were improved rapidly. Bilateral biopsy of temporal arteries performed immediately prior to the treatment showed giant cell arteritis. [Discussion] FDG-PET CT is known to be extremely effective for the diagnosis of GCA. The sensitivity and specificity of FDG-PET CT for the diagnosis of GCA are 89.5% and 97.7%, respectively. We experienced the case of GCA without positive FDG-PET CT findings whereas contrast-enhanced MRI showed positive findings. We present the case with a review of the literature.
