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30 year old female with asymmetric arm pulses, vague pelvic and lower extremity pain, and fatigue

Takayasu’s Arteritis

• Image findings: Narrowed origin of the right subclavian artery. Characteristic long, tapered narrowing of the distal aorta and iliac vessels.

• Takayasu’s arteritis is a granulomatous vasculitis that primarily involves that thoracic and abdominal aorta and its large branch vessels. Fibrotic stenoses eventually develop in the involved vessels. Aneurysms may also be found. It occurs most commonly in women under the age of 50

• Patients typically present with neurologic symptoms, history of stroke, asymmetric arm blood pressures and/or pulses. Can also display mylagias, fatigue, low-grade fever, tachycardia, and pain adjacent to inflamed arteries

• Radiographic features: Stenoses of arch vessels (most common), stenosis and occlusion of aorta (may mimic coarctation), thickening of aortic wall, pulmonary artery involvement (50%), abdominal coarctation and renal stenoses.

• Giant Cell arteritis: Involves older patients, > 50 year old. Diagnosed with biopsy of temporal artery. Most commonly involves medium sized arteries. Aorta is involved in 10%, most commonly ascending aorta. Complications: aneurysm, dissection.

Types:

• Type 1: Aortic arch

• Type 2: Abdominal aorta

• Type 3: Entire aorta

• Type 4: Pulmonary arteries