A 44-year-old female presents to the emergency department with a right-sided headache. She reports the headache is located on the right temple region, is non-radiating, and does not cause photophobia. She is otherwise healthy with no reported medical problems and takes acetaminophen for the pain, which provides minimal relief. On physical examination, she is alert, awake, and oriented. Her vital signs are T 98.8°F, P 78 bpm, R 18 breaths/min, and BP 128/76 mmHg. Her head is normocephalic, atraumatic, and pupils are equal and reactive. There is tenderness in the right temporal area of the temporal artery, with no swelling, redness, or abnormalities noted. There is no tenderness in the cervical muscles, and her neurological exam is non-focal.

Based on the description, what is the most likely diagnosis of this patient?

A. Migraine headache
B. Tension headache
C. Cluster headache
D. Temporal arteritis
E. Takayasu arteritis

The most likely diagnosis for this patient is temporal arteritis, an inflammatory condition that affects the medium and large arteries, typically involving the temporal artery. It requires treatment with corticosteroids to reduce inflammation and prevent complications.

Explanation:

The most likely diagnosis for this patient based on the description is temporal arteritis. Temporal arteritis, also known as giant cell arteritis, is an inflammatory condition that affects the medium and large arteries, typically involving the temporal artery.

Patients with temporal arteritis often experience unilateral headaches, tenderness over the affected artery, and symptoms such as fatigue, fever, and vision changes.

This condition is more common in individuals over the age of 50 and can lead to serious complications if left untreated. It typically requires treatment with corticosteroids to reduce inflammation and prevent complications.