Atypical giant cell arteritis presenting as lack of a pulse in the upper extremity.

Giant cell arteritis (GCA), an inflammatory vasculopathy that preferentially affects medium-sized and large arteries, has diverse symptoms and varied clinical courses that can make the diagnosis difficult. We describe a 75-year-old woman in whom GCA presented as lack of a pulse in the right arm. Although steroid therapy is generally effective for treating GCA, surgical intervention provides a biopsy specimen for a definitive diagnostic study and restores blood flow in the affected limb. GCA should be considered along with atherosclerosis in cases of occlusive disease of the upper extremity, especially if the patient is an elderly woman.