What causes painful swelling in the temples?
Need to rule out temporal arteritis
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Bulging temporal vein, especially while straining, can be normal/physiological.
But the associated tenderness on touching is concerning.
Such pain raises the concern for temporal arteritis.
Temporal arteritis requires prompt treatment with steroids, to avoid complications especially to the eye and vision.
Blood ESR levels are used as an increased screening, followed by temporal artery biopsy to confirm temporal arteritis. If ESR is elevated steroids will be started even before the biopsy.
Please be advised to follow up with your primary care provider/urgent care as soon as possible.
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