Nineteen of 520 patients with biopsy-proven giant cell arteritis were found to have persistent seronegative, symmetric polyarthritis with a mean joint count of 20 (swollen plus tender), In 9 patients in the onset of polyarthritis occurred prior to the diagnosis of giant cell arteritis, 3 had simultaneous onset, and 7 developed polyarthritis within 3 years after the onset of giant cell arteritis. Ten of the 19 patients demonstrated radiographic features of joint space narrowing and/or erosions. In 1 patient in a synovial biopsy was performed, revealing marked multinucleated giant cell infiltration. A persistent seronegative polyarthritis, although uncommon in giant cell arteritis, may be its presenting symptom. Other symptoms of giant cell arteritis should be sought in patients who exhibit this feature, especially in those whose arthritis begins at age 50 or older.
Giant cell arteritis (GCA) is an idiopathic granulomatous vasculitis predominantly affecting the medium-sized and large branches of the arteries arising from the arch of the aorta. While headache and visual disturbance are common symptoms of involvement of cranial arteries, a wide variety of systemic and less specific manifestations of giant cell arteritis have been recognized in recent years (1,2). Such manifestations include respiratory symptoms of cough and hoarseness, fever of unknown origin, anemia, and a From the