Jaw Dropping: The Necessity of a History and a Biopsy in Suspected Temporal Arteritis

Abstract

We describe an 82-year-old man who was diagnosed with temporal arteritis (TA) on the basis of a 12-month history of jaw pain and intermittent deafness. The erythrocyte sedimentation rate (ESR) was 80 mm/hr, but there was no thrombocytosis and the patient’s jaw pain did not resolve with steroids. No temporal artery biopsy (TAB) was performed, and the patient went on to develop significant complications of long-term therapy with corticosteroids in the form of mandibular necrosis and fracture, cataracts, and postoperative endophthalmitis. The diagnosis was incorrect. This case stresses that much of the morbidity in TA is from the steroids, especially in the older age group. The diagnostic pathway in TA mandates a comprehensive and accurate history of the disorder, an assessment of its signs, and the performance of an adequate TAB.

Keywords::

• biopsy
• corticosteroids
• temporal arteritis

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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