Rare orbital manifestations and vasculitis, giant cell arteritis or side effects of zoledronic acid infusion?

Giant cell arteritis (GCA), affects an age group where osteoporosis is common. A well-established treatment for osteoporosis is medication with bisphosphonates. Bisphosphonates are overall welltolerated but can trigger several different acute inflammatory reactions with systemic features and symptoms and signs from the ocular and musculoskeletal system, all of which resemble those of GCA. Here is described a second case of GCA brought about by zoledronic acid infusion, presenting with cranial, orbital and systemic features; diagnosed through ultrasound with both cranial and extra-cranial vessel involvement and successfully treated with glucocorticoids