Tracing Horton’s disease in Renaissance artworks: the first International Society of Iconodiagnosis systematic iconodiagnosis cases review on a specific disease

Iconodiagnosis is the medical analysis of pathological signs depicted in historical artworks. As part of the activities of the International Society of Iconodiagnosis (ISI), we are initiating a series of systematic reviews organized by type of iconodiagnosis. These efforts aim to support the compilation of data to enable semi-quantitative analysis. We begin this series with artworks that depict visual signs suggestive of temporal arteritis, also known as Horton’s disease, already published in scientific literature indexed in PubMed, as a first phase.

In accordance with PRISMA 2020 guidelines, we developed a systematic review protocol, including predefined eligibility criteria and a structured data extraction strategy.

We report 8 historical artworks from the Renaissance period, each depicting visual clinical features - primarily dilation and tortuosity of the superficial temporal arteries - consistent with temporal arteritis. These include works by Italian painters such as Filippino Lippi and Piero di Cosimo, as well as Flemish artists like Jan van Eyck, among others, currently housed in museums across Europe and the United States.

Two cases are supported by historical documentation regarding the identity and medical history of the individuals portrayed, confirming the iconodiagnosis. This highlights the importance of interdisciplinary collaboration between physicians and art historians.
The convergence of artistic realism and anatomical precision in these Renaissance artworks has transformed them into valuable sources for semiological and epidemiological study. In a second phase, this review will be expanded to include additional cases reported in books and non-indexed sources.