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Cranial ultrasound may replace temporal artery biopsy in diagnosis of giant cell arteritis
Date:6/12/2014

simpler, more accurate diagnostic test. The high predictive accuracy of cranial ultrasound over temporal artery biopsy indicated that temporal artery biopsy may now be unnecessary, particularly where clinical suspicion of GCA is high or quite low," Dr Croft added.

Out of a total of 87 patients who underwent cranial ultrasound for suspected GCA, 36 patients (41%) had a confirmed clinical diagnosis at the three month follow-up. Of the 30 patients who had a positive cranial ultrasound, 29 (96%) went on to have a confirmed diagnosis of GCA at three months. Of the 36 patients with more than three ACR criteria, only 21 (58%) had a diagnosis of GCA confirmed at three months.

"Being able to reliably confirm the diagnosis is important not just to ensure those patients with GCA receive high-dose steroids to help prevent blindness, but also to prevent patients who don't have GCA continuing high-dose steroid therapy unnecessarily. High doses of steroids can cause a variety of unpleasant side effects including weight gain, infection risk, osteoporosis and fracture risk, high blood pressure, diabetes, cataracts," Dr Adam Croft explained.

When compared to clinical diagnosis at three months, the sensitivity of cranial ultrasound was 81%, specificity 98%, positive likelihood ratio 41, negative likelihood ratio 0.2, positive predictive value of 97% and negative predictive value of 88%. In contrast, when compared to clinical diagnosis at three months TAB had a sensitivity of 53%, specificity 100%, positive likelihood ratio 2.3, negative likelihood ratio 0.2, positive predictive value of 100% and negative predictive value of 47%. Over the last 25󈞊 years, GCA has been found to be the most common type of vasculitis in Europe and North America, especially in people aged >70 years. GCA mainly affects white individuals, and it almost exclusively occurs in subjects aged >50 years. The cause of giant cell arteritis is unclear; however, it is thought that a
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Contact: EULAR Press Office
eularpressoffice@cohnwolfe.com
44-078-801-73209
European League Against Rheumatism
Source:Eurekalert

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