1. Large vessel Arteritis

38. GEOGRAPHICAL VARIATION OF AFFECTED VESSELS 38 52 8 Renal 65 22 11 Abdominal aorta 58 7 20 Common carotid 98 38 68 Aortic arch& branches NORTH AMERICA INDIA JAPAN

39. TAKAYASU CLASSIFICATION 1 Aortic arch 2a 1+ As Aorta 2b 2a+ thoracic aorta 3 Thoracic+ Abdominal aorta 4 Abdominal aorta 5 Entire aorta

42. Takayasu- Uppal et al

53. 1. All patients on long term steroids should be given lifestyle advice: a)Adequate Calcium (1000mg/d) and vitamin D (800units/d) intake b) Weight bearing exercise (20 minutes brisk walking daily) c) avoid tobacco and excess alcohol. 2. Patients who require steroid treatment with pred. at 7.5mg/day or more for 6 months or longer should have a bone density assessment using DEXA scanning. a) If DEXA result is Normal ie T score greater than –1.0, no other treatment is recommended. b) If DEXA shows osteopaenia, ie T score between –1.0 and –2.5, then treatment should be started if there has been a previous low impact fracture. c) If DEXA shows osteoporosis, ie T score below –2.5, treatment should be started.

61. 1. All patients on long term steroids should be given lifestyle advice: a)Adequate Calcium (1000mg/d) and vitamin D (800units/d) intake b) Weight bearing exercise (20 minutes brisk walking daily) c) avoid tobacco and excess alcohol. 2. Patients who require steroid treatment with pred. at 7.5mg/day or more for 6 months or longer should have a bone density assessment using DEXA scanning. a) If DEXA result is Normal ie T score greater than –1.0, no other treatment is recommended. b) If DEXA shows osteopaenia, ie T score between –1.0 and –2.5, then treatment should be started if there has been a previous low impact fracture. c) If DEXA shows osteoporosis, ie T score below –2.5, treatment should be started.