An older adult complains of fatigue, stiffness in the shoulders and neck, and episodes of transient visual loss. What condition do these findings most likely suggest?

The combination of symptoms presented—fatigue, stiffness in the shoulders and neck, and episodes of transient visual loss—strongly suggests giant cell (temporal) arteritis. This condition is characterized by inflammation of the large and medium-sized blood vessels, often affecting the temporal arteries but can also involve other vessels in the head, neck, and even systemic circulation.

Fatigue is a common systemic symptom associated with this condition, alongside stiffness and muscle pain, particularly in the neck and shoulder regions, as this inflammation can impact nearby structures. The transient visual loss is particularly concerning in the context of giant cell arteritis, as it can lead to permanent vision loss if not treated promptly due to potential involvement of the ophthalmic artery.

Sjögren's syndrome primarily presents with dry eyes and mouth, and while it can cause fatigue and joint stiffness, it does not typically involve transient visual loss. Migraine headaches may present with visual disturbances, but they usually are not associated with the other symptoms of stiffness and fatigue described here. Glaucoma primarily affects intraocular pressure and vision but does not typically produce the generalized systemic symptoms of fatigue and stiffness in the way giant cell arteritis does.

In summary, the distinctive combination of systemic fatigue, localized stiffness in the neck and