ROSH Geriatrics Practice Test

In this scenario, the most likely diagnosis is giant cell arteritis (GCA), particularly given the presentation of right temporal tenderness and recent onset of headaches. GCA is an inflammatory disease affecting the large and medium-sized blood vessels, which most commonly involves the temporal arteries.

The symptom of temporal tenderness is particularly characteristic of GCA, often described as a deep-seated pain in the temple area that can be exacerbated by touch. Recent onset headaches, especially in an older adult, raise suspicion for this condition, as it often presents with new or different headache patterns in individuals over the age of 50.

Additionally, GCA can lead to serious complications, such as blindness, if not promptly treated with corticosteroids, making early diagnosis crucial. Key indicators such as elevated sedimentation rate (ESR) or C-reactive protein (CRP), often accompany the clinical picture, further supporting the diagnosis.

While other options like cluster headache, fibromyalgia, and trigeminal neuralgia may involve head pain or tenderness, they do not typically present with temporal artery tenderness and the acute nature associated with GCA. Cluster headaches have a more distinct cyclical pattern and presentation, fibromyalgia involves widespread pain and tender points, and trigeminal neuralgia