Spot the Abnormality? | Figure 1

msputman

Rheumatology

A 72 year old female patient presents to your clinic with fatigue, elevated inflammatory markers, and reports from a vascular surgeon that "I think she has vasculitis."

The surgeon reports highly abnormal blood vessels in the femoral artery, which he noted during an endarterectomy.

An outside hospital rheumatologist recommended temporal artery biopsies, which were negative. The surgeon disagreed and requested a second opinion.

Who is right based on this MRA?

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