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Giant Cell Arteritis

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Giant cell arteritis (GCA)—a type of vasculitis—is a group of diseases whose typical feature is inflammation of blood vessels. The blood vessels most commonly involved are the arteries of the scalp and head (especially the arteries over the temples), which is why another term for GCA is “temporal arteritis.” GCA can overlap with another rheumatic disease called polymyalgia rheumatica, and symptoms of the two conditions can occur at the same time or separately. The causes of GCA and polymyalgia rheumatica are unknown.

Osteonecrosis

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Osteonecrosis, also called avascular necrosis or aseptic necrosis, is a condition in which the death of bone cells (due to decreased blood flow) can lead to pain and collapse of areas of bone. This collapse of bone, in turn, can lead to degenerative arthritis of nearby joints, most commonly the hips and knees. Less frequently affected are the shoulders, hands, and feet. In rare instances, osteonecrosis can occur in the jaw— resulting in pain and mouth ulceration. Osteonecrosis is not fatal, but can lead to pain, arthritis, problems with physical activity, and even the need for joint replacement. Most of the 10,000 to 20,000 Americans developing osteonecrosis annually are between age 20 and 50. These individuals usually have a history of serious trauma, corticosteroid use, excess alcohol intake, or other conditions including systemic lupus erythematosus, dysbarism (“the bends” that occur with scuba diving), blood disorders, HIV infection, and radiation therapy.