Adults
Takayasu arteritis / large-vessel vasculitis
Limb claudication, absent or unequal pulses and bruits, usually in a younger patient.
What to look for
- Usually onset before age 40, though 2022 ACR/EULAR classification allows up to 60
- Arm or leg claudication, a reduced pulse, or a systolic BP difference between arms (20 mm Hg or more scores in the 2022 classification criteria)
- Carotid, subclavian or abdominal bruits, carotidynia, hypertension
- Constitutional symptoms and raised inflammatory markers
What to do
- Get CTA or MRA of the aorta and its branches. PET may be used by specialists.
- Send ESR, CRP, CBC and a metabolic panel.
- Ischemic symptoms (stroke or TIA, mesenteric or limb ischemia) are emergent.
About this urgency level
Early specialist assessment changes outcomes. Send the usual workup with the referral, but don't hold the referral while waiting for results.
Timeframes are typical targets. Local pathways, capacity and clinical judgment come first.