Listen to the axillary artery: diagnosis of occult giant cell arteritis.

Large-vessel involvement is increasingly recognized in giant cell arteritis (GCA) and frequently occurs with an unspecific systemic inflammatory syndrome or fever of unknown origin. We describe the case of a 68-year-old woman with a history of polymyalgia rheumatica who presented with progressive weight loss, unexplained anemia, and a marked humoral inflammatory response. Diagnosis of large-vessel GCA was facilitated by axillary artery auscultation, revealing a bilateral axillary artery bruit. The diagnosis was confirmed by color duplex sonography and temporal artery biopsy. In elderly patients with an unspecific systemic inflammatory condition, axillary artery auscultation is a simple but valuable tool for detection of underlying occult large-vessel GCA.