Which condition presents with jaw claudication and scalp tenderness, with ESR often markedly elevated and diagnosed by temporal artery biopsy?

• A. Aortic Dissection
• B. Giant Cell Arteritis
• C. Phlebitis
• D. Peripheral Artery Disease

Answer: (B)

Jaw claudication with scalp tenderness points to ischemia of the head’s vessels, a hallmark of a large‑vessel vasculitis known as giant cell arteritis. This condition typically affects people over 50 and causes systemic inflammation, which explains the markedly elevated ESR. The temporal artery biopsy is used to confirm the diagnosis because it reveals granulomatous inflammation with multinucleated giant cells in the vessel wall, along with changes like intimal thickening. This combination of symptoms and biopsy finding is distinctive for giant cell arteritis and set apart from other vascular or inflammatory processes such as aortic dissection (which presents with sudden severe chest or back pain), phlebitis (vein inflammation with different sensory signs), or peripheral artery disease (limb claudication rather than head/temporal symptoms).