Do you typically screen every patient with headaches after the age of 60 with ESR?

I would not. Many patients will have elevated ESR because of other conditions (for example, chronic kidney disease). The history is going to be key in determining which cases to send for lab testing.

It depends on the patient's presentation. In a patient with long-standing headaches that have not changed in character but are over 60, an ESR to screen for giant cell arteritis is not the first place I would go. However, in a patient without a history of headaches or with a significant change in th...

Rheumatologist here! The challenge of checking ESR/CRP for isolated headaches without other symptoms concerning GCA is the high likelihood of picking up elevated inflammatory markers without actual GCA (given prevalence in certain chronic conditions such as CKD/ESRD, or sometimes elevated CRP seen i...

I routinely check ESR and CRP for new onset headaches in individuals over 50, depending on the clinical scenario, while excluding other obvious red flags where appropriate. Additionally, I request CBC with platelets if recent labs are available, as increasing thrombocytosis can be a valuable indicat...

Provocative question, and the answer is no (but patients rarely visit a rheumatologist for headaches). However, a patient with a new-onset headache that is secondary to GCA constitutes a medical emergency and cannot be slowly approached for diagnosis.

The diagnosis of GCA and PMR remains both an art...

The answer, as is often the case, is "it depends". Personally, I would not screen every such person. If the history suggests PMR and/or GCA, I would conduct ESR and CRP tests. If there is hard evidence, I would consider a biopsy. However, if there is little or no reason to suspect either GCA or PMR,...