Giant Cell Arteritis Presenting As Headache, Neck Pain, and Musculoskeletal Complaints: A Case Series

BACKGROUND: Giant cell arteritis (GCA) is a systemic vasculitis affecting medium and large arteries, primarily in adults over 50. Untreated, GCA can cause serious complications like vision loss and stroke. It often mimics musculoskeletal issues (e.g., headaches, jaw, neck), leading to more visits to non-physician providers like physical therapists. This case series highlights two different GCA presentations seen in an outpatient PT setting, demonstrating the clinical reasoning and referral processes essential for timely diagnosis and treatment. CASE PRESENTATION: Two patients presented to outpatient PT with symptoms consistent with mechanical MSK dysfunction. Initial examinations, including neurologic screening, were unremarkable and consistent with common MSK conditions. OUTCOME AND FOLLOW-UP: Symptoms like scalp tenderness, jaw fatigue, and visual disturbances led to medical evaluation. Both patients were diagnosed with GCA and treated with corticosteroids, resolving their systemic symptoms. DISCUSSION: PTs can play a critical role in the early detection of GCA, even when symptoms are masked by trauma or other conditions. Increased awareness of GCA's musculoskeletal mimicry, systematic screening for red flags, and good communication with physicians are essential to prevent serious complications like vision loss. PT education should focus on improving GCA recognition in non-physician settings.