Giant cell arteritis should not be a diagnosis of exclusion, an afterthought, or a last thought. There is urgency to establishing this diagnosis and initiating therapy. All practitioners who treat adults will be confronted with these patients. Some will have classic presentations, some will have subtle presentations. When patients complain of fever, fatigue, malaise, weight loss, or painless vision loss, GCA should be suspected. An ESR will aid in the diagnosis (although a normal ESR does not rule it out), and sometimes temporal artery biopsy will provide certainty. Giant cell arteritis is usually easy to recognize, easy to treat, and satisfying to manage.
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