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Giant Cell Arteritis Temporal Arteritis Referral Access Criteria

Giant Cell Arteritis Temporal Arteritis Referral Access Criteria

Referrers should use this page when referring patients to public adult rheumatology outpatient services for Giant Cell Arteritis / Temporal Arteritis.
Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
  • Visual disturbance or loss
  • Complications of disease or therapy requiring emergency review
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate rheumatology assessment (seen within 7 days):
  • Please refer patients meeting the following criteria for immediate review:
    • Age > 50
    • Suspected giant cell arteritis e.g. new headache, jaw claudication, scalp sensitivity, tenderness over the temporal arteries, fevers, visual disturbance.
    • No other diagnosis is more likely

To contact the relevant service, see HealthPathways: Acute Rheumatology Assessment (external site).
Presenting issues
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  • New onset of headaches (usually unilateral)
  • Fatigue
  • Weight loss
  • Tender scalp or temples
  • Sudden vision loss, blurred or double vision
  • Jaw claudication
  • Dizziness
  • Poor coordination and balance
  • Persistent sore throat
  • Dysphagia
  • Fevers and sweats
  • Dry cough
Mandatory information
Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test due to financial reasons or geographical location).

This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.
History
  • Relevant history:
    • Age of onset of symptoms greater than 50 years
    • Onset and time since onset of headaches, visual disturbance, jaw claudication, scalp tenderness
  • Current medication list
  • Any known allergies
  • Details of previous treatment (including steroid exposure) and outcome
Examination
  • Nil
Investigations
  • FBC
  • LFTs
  • ESR
  • CRP
Highly desirable
History
  • Other screening previously performed including HepB, HepC, HIV, QuantiFERON Gold (QFG)
Examination
  • Nil
Investigations
  • Temporal artery biopsy histology
  • Bone mineral density
  • PET, CT, CXR or USS
Indicative triage category

Category 1

Appointment within 30 days

  • No defined category 1 criteria

Category 2

Appointment within 90 days

  • Stable giant cell arteritis on treatment

Category 3

Appointment within 365 days

  • No defined category 3 criteria
Exclusions
  • Patients aged <45 years. The incidence of Giant Cell Arteritis in this patient cohort is rare.
  • Chronic headaches.
    • May be appropriate for referral to Neurology. See Neurology RAC.
Useful information
Last reviewed: 18-03-2024
wa.gov.au