Rheumatology Question 11

A 73 year old man presents to you complaining of a new left-sided temporal headache. His scalp is painful when he combs his hair. His jaw becomes tired and sore after a few minutes of chewing and he has had low-grade fevers in the past few weeks. These symptoms have developed in the context of a 3 month history of aching in the shoulders and hip girdle. His ESR is 90.

You are concerned that he may have temporal arteritis and decide to obtain a biopsy of the left temporal artery. Should you wait for the biopsy to be performed before treating this patient with high-dose steroids? Why or why not?

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