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Temporal arthritis is a type of arthritis not many people are aware of. It is also known as giant cell arthritis, and is defined as an inflammation of the medium and large arteries that run along each side of the head. It occurs concurrently with polymyalgia rheumatica, a disorder causing extreme pain and stiffening of the muscles in the pelvis and shoulder, about 25 percent of the time.

Temporal arthritis generally affects those over 50 years of age and begins slowly. The patient may feel just generally weary or not quite well. He may lose a little weight, experience minor temperatures, and minor aches in muscles and joints, especially in the hips or shoulders. This can go on for several weeks.

At some point the large major arteries start to become inflamed. The temporal arteries for which the disease is named run from your neck up to the sides of your head near your temples, supplying the jaw, the scalp and top of the head with blood. With this artery being swollen, symptoms like headache and jaw soreness are to be expected, the latter especially after eating or talking. Sudden pain around the temples is often the first symptom that will concern the patient. Some find that combing their hair even seems painful. Blurred vision is a more serious symptom. Others may include shaking, sweating and stiffness in the joints. If the disease has progressed, another very rare symptom is blindness, as this artery also supplies blood to the optic nerve.

Blindness is the primary concern of temporal arthritis. This is fairly easily prevented with prompt treatment to reduce the swelling of the artery. This can be accomplished with prednisone quite effectively. If left untreated, however, the inflammation can prevent blood from reaching the optic nerve in sufficient quantities to keep the retina and optic nerves alive. If allowed to progress further, temporal arthritis can affect other major arteries in the body.

Like other types of arthritis, we don’t know what causes temporal arthritis, but a defect in the immune system response is suspected. Along with polymyalgia rheumatica, temporal arthritis has also been tied to serious infections, use of antibiotics in high doses, and certain chronic disorders including lupus.

Diagnosis is made by several indications:

- A tender, thicker-than-usual artery is visible on one side of the head. It is tender to the touch and is probably accompanied by scalp tenderness.

- This artery may have no pulse or a very faint pulse due to the inflammation blocking the blood flow.

- A dry cough or other respiratory complaints may be present.

- There may be pain in nerve groups

- Fever with no other explanation

- Paralysis of the eye muscles can occur, but this is, thankfully, rare.

- Blood tests are non specific, but can be indicative of temporal arthritis if ESR is high, while hemoglobin or hematocrit are low and alkaline phosphates may be high.

- Liver function may be abnormal

A biopsy may be taken to confirm the visual and blood work indications. Prednisone is usually prescribed to reduce the swelling. Aspirin may be suggestion in addition. Occasionally a patient may need additional medication that will suppress the immune system.

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