TEMPORAL ARTERITIS - THE SILENT PRESENTATION AND DELAY IN DIAGNOSIS

Abstract. To determine the frequency of the so‐called silent or occult presentation of temporal arteritis (presentation with mere constitutional symptoms) and the resulting delay in diagnosis in this particular group, the medical records of all patients (n = 82) with temporal arteritis or polymyalgia rheumatica, presenting between 1982 and 1988 at the Department of General Internal Medicine of the University Hospital, were retrospectively analysed. Only biopsy‐proven cases (n = 34) were studied further. Of the 34 patients with temporal arteritis, 13 (38%) presented with the silent or occult form. In this group the mean delay in diagnosis was 21.5 d (range 2–105) in contrast to a delay of 8.5 d (range 1–40) in the other group (P < 0.05). Increased awareness of this presentation should lead to earlier diagnosis and treatment of this potentially life‐threatening disease, resulting in a shorter hospital stay and fewer technical investigations, with a considerable financial saving. 1990 Blackwell Publishing Ltd