Name

Birth Date

Age

Gender

Male Female

Residency

--< Select >-- Cairo Giza Alexandria Port Said Suez Demiatt Dakahlia Sharkia Qalyoubia Kafr Shaikh Gharbia Menouffia Behaira Ismaillia Beni Suif Fayoum Minia Assuit Sohag Qena Asswan Luxor Al Bahr Al Ahmar Al Wadi Al Gaddid Matrouh N. Sinai S. Sinai Other Country

Occupation

Weight (kg)

Height (m)

BMI (Body Mass Index)

Smoking

Yes No

Informed Consent

New headache

None Unilateral Bilateral

Temporal artery abnormality

Yes No

Jaw claudication

Yes No

Associated PMR

Yes No

ESR

CRP

Temporal artery US (Halo sign)

Positive Negative

Temporal artery Biopsy

CT angiography

MRI

PET

Claudication

Yes No

Decreased Brachial artery pulse

Yes No

Systolic blood pressure

Diastolic blood pressure

Bruit

Yes No

Biopsy

Weight loss

Yes No

Livedo Reticularis

Yes No

Myalgia

Yes No

Testicular pain

Yes No

Mononuritis multiplex / Polyneuropathy

Yes No

Urea

Hepatitis B surface antigen

Positive Negative

Arteriographic abnormalities

Nasal inflammation

Yes No

Oral ulcers

Yes No

Hematuria

None Microhematuria Macroscopic hematuria

Nasal sinus inflammation

Yes No

X-ray Chest

Granulomatous inflammation on biopsy

Recurrent oral ulcers

Yes No

Recurrent genital ulcers

Yes No

Ocular affection

Yes No

Vascular lesions

Yes No

Pathergy test

Positive Negative

Skin manifestations

Neurological affection

Yes No

Management of Behcet