{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T07:44:23Z","timestamp":1767339863669,"version":"3.41.2"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T00:00:00Z","timestamp":1694476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Giant cell arteritis (GCA) is a kind of systemic vasculitis affecting individuals over 50 years old and is often the cause of new-onset headaches in older adults. Patients with GCA sometimes have rheumatic polymyalgia (PMR). The diagnosis of GCA generally depends on clinical manifestation, elevated erythrocyte sedimentation rate (ESR) or C-reactive protein, and positive imaging findings commonly obtained by ultrasound or temporal artery biopsy. In this study, we report a case of an 83-year-old woman with a new-onset headache and an elevated ESR. The result of the temporal artery ultrasound did not distinguish between vasculitis and atherosclerosis. The F18-fluorodeoxyglucose positron emission tomography and computed tomography (18F FDG PET-CT) were performed and suggested large vessel vasculitis with temporal artery involvement. In addition, polyarticular synovitis and bursitis were also revealed. Finally, the diagnosis of secondary headache attributed to CGA complicated with PMR was established. The patient experienced remission of symptoms after glucocorticoid therapy. PET can become a powerful tool for diagnosis and differential diagnosis when the ultrasound result is ambiguous and a biopsy is not obtained.<\/jats:p>","DOI":"10.3389\/fneur.2023.1241676","type":"journal-article","created":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T11:08:53Z","timestamp":1694516933000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Headache attributed to giant cell arteritis complicated with rheumatic polymyalgia diagnosed with F18-fluorodeoxyglucose positron emission tomography and computed tomography: a case report"],"prefix":"10.3389","volume":"14","author":[{"given":"Dong","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zunjing","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huailian","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinhua","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Peng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,9,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1056\/NEJMra022694","article-title":"Medium- and large-vessel vasculitis","volume":"349","author":"Weyand","year":"2003","journal-title":"N Engl J Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1016\/j.semarthrit.2020.07.005","article-title":"Incidence and prevalence of giant cell arteritis and polymyalgia rheumatica: a systematic literature review","volume":"50","author":"Sharma","year":"2020","journal-title":"Semin Arthritis Rheum."},{"key":"B3","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1016\/j.ajem.2022.05.042","article-title":"High risk and low prevalence diseases: giant cell arteritis","volume":"58","author":"Lacy","year":"2022","journal-title":"Am J Emerg Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/S0140-6736(12)60680-1","article-title":"Polymyalgia rheumatica","volume":"381","author":"Kermani","year":"2013","journal-title":"Lancet."},{"key":"B5","doi-asserted-by":"publisher","first-page":"s134","DOI":"10.1007\/s10072-005-0426-5","article-title":"Headache in giant cell arteritis and other arteritides","volume":"26","author":"Ward","year":"2005","journal-title":"Neurol Sci."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1122","DOI":"10.1002\/art.1780330810","article-title":"The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis","volume":"33","author":"Hunder","year":"1990","journal-title":"Arthritis Rheum."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1647","DOI":"10.1136\/ard-2022-223480","article-title":"2022 American College of Rheumatology\/EULAR classification criteria for giant cell arteritis","volume":"81","author":"Ponte","year":"2022","journal-title":"Ann Rheum Dis."},{"key":"B8","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/j.ultrasmedbio.2020.10.004","article-title":"Temporal artery ultrasound to diagnose giant cell arteritis: a practical guide","volume":"47","author":"Noumegni","year":"2021","journal-title":"Ultrasound Med Biol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"275","DOI":"10.3390\/jcm11010275","article-title":"Temporal artery vascular diseases","volume":"11","author":"Greigert","year":"2022","journal-title":"J Clin Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"2443","DOI":"10.1093\/rheumatology\/kez641","article-title":"False positives in the ultrasound diagnosis of giant cell arteritis: some diseases can also show the halo sign","volume":"59","author":"Fernandez-Fernandez","year":"2020","journal-title":"Rheumatology."},{"key":"B11","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1136\/annrheumdis-2017-212649","article-title":"EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice","volume":"77","author":"Dejaco","year":"2018","journal-title":"Ann Rheum Dis."},{"key":"B12","doi-asserted-by":"publisher","first-page":"e000612","DOI":"10.1136\/rmdopen-2017-000612","article-title":"Imaging in diagnosis, outcome prediction and monitoring of large vessel vasculitis: a systematic literature review and meta-analysis informing the EULAR recommendations","volume":"4","author":"Duftner","year":"2018","journal-title":"RMD Open."},{"key":"B13","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1002\/art.41165","article-title":"Diagnostic assessment strategies and disease subsets in giant cell arteritis: data from an international observational cohort","volume":"72","author":"Gribbons","year":"2020","journal-title":"Arthritis Rheumatol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1093\/rheumatology\/kez385","article-title":"Sensitivity of temporal artery biopsy in the diagnosis of giant cell arteritis: a systematic literature review and meta-analysis","volume":"59","author":"Rubenstein","year":"2020","journal-title":"Rheumatology."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1250","DOI":"10.1007\/s00259-018-3973-8","article-title":"FDG-PET\/CT(A) imaging in large vessel vasculitis and polymyalgia rheumatica: joint procedural recommendation of the EANM, SNMMI, and the PET Interest Group (PIG), and endorsed by the ASNC","volume":"45","year":"2018","journal-title":"Eur J Nucl Med Mol Imaging."},{"key":"B16","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1016\/j.jcmg.2012.01.013","article-title":"Role of FDG PET-CT in Takayasu arteritis: sensitive detection of recurrences","volume":"5","author":"Tezuka","year":"2012","journal-title":"JACC Cardiovasc Imaging."},{"key":"B17","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1053\/j.semnuclmed.2017.02.005","article-title":"Clinical value of FDG-PET\/CT for the evaluation of rheumatic diseases: rheumatoid arthritis, polymyalgia rheumatica, and relapsing polychondritis","volume":"47","author":"Kubota","year":"2017","journal-title":"Semin Nucl Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"705","DOI":"10.3109\/s10165-011-0581-x","article-title":"Whole-body fluorodeoxyglucose positron emission tomography\/computed tomography in patients with active polymyalgia rheumatica: evidence for distinctive bursitis and large-vessel vasculitis","volume":"22","author":"Yamashita","year":"2012","journal-title":"Mod Rheumatol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"e0158509","DOI":"10.1371\/journal.pone.0158509","article-title":"Differentiation between polymyalgia rheumatica (PMR) and elderly-onset rheumatoid arthritis using 18F-fluorodeoxyglucose positron emission tomography\/computed tomography: is enthesitis a new pathological lesion in PMR?","volume":"11","author":"Wakura","year":"2016","journal-title":"PLoS ONE."},{"key":"B20","doi-asserted-by":"publisher","first-page":"546","DOI":"10.3109\/14397595.2014.978936","article-title":"Differences in fluorodeoxyglucose positron emission tomography\/computed tomography findings between elderly onset rheumatoid arthritis and polymyalgia rheumatica","volume":"25","author":"Takahashi","year":"2015","journal-title":"Mod Rheumatol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1136\/ard.60.11.1021","article-title":"Presenting features of polymyalgia rheumatica (PMR) and rheumatoid arthritis with PMR-like onset: a prospective study","volume":"60","author":"Caporali","year":"2001","journal-title":"Ann Rheum Dis."},{"key":"B22","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1016\/j.ymed.2012.09.009","article-title":"2012 Provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism\/American College of Rheumatology collaborative initiative","volume":"64","author":"Dasgupta","year":"2012","journal-title":"Arthritis Rheum."},{"key":"B23","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1136\/bcr-2022-250318","article-title":"Giant cell arteritis of the middle cerebral artery","volume":"15","author":"Kinoshita","year":"2022","journal-title":"BMJ Case Rep"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1241676\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T11:08:56Z","timestamp":1694516936000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2023.1241676\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,12]]},"references-count":23,"alternative-id":["10.3389\/fneur.2023.1241676"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2023.1241676","relation":{},"ISSN":["1664-2295"],"issn-type":[{"type":"electronic","value":"1664-2295"}],"subject":[],"published":{"date-parts":[[2023,9,12]]},"article-number":"1241676"}}