Ann Intern Med
Study validates ultrasound-only approach to giant cell arteritis diagnosis
Among patients with high clinical suspicion of giant cell arteritis (GCA), positive findings on Doppler ultrasound of the temporal arteries meant that further diagnostic tests could be avoided.
In this prospective multicenter study with 2 years of follow-up, 165 patients with high clinical suspicion of GCA (median age, 79 years) were referred by their PCP or ophthalmologist to a physician with extensive experience in GCA diagnosis and management. Color Doppler ultrasound was performed <7 days after initiation of corticosteroid therapy. Only those patients with negative ultrasound findings underwent temporal artery biopsy (TAB). Ultrasound was considered positive if bilateral temporal halo signs were seen. Ultrasound and TAB findings were compared with physician-diagnosed GCA based on clinical findings and other imaging.
Diagnosis of GCA was confirmed in 44%, 17%, and 21% of participants by ultrasound, TAB, and clinical expertise and/or other imaging tests, respectively. Diagnosis remained unchanged at 1 month and at 2 years for those with available follow-up data. In 18% of participants, an alternative diagnosis was made. The proportion of ultrasound-positive patients among those with clinically diagnosed GCA was 54% (95% confidence interval, 45% to 62%).
Source:
Denis G, et al. (2024, May 7). Ann Intern Med. Diagnostic Strategy Using Color Doppler Ultrasound of Temporal Arteries in Patients With High Clinical Suspicion of Giant Cell Arteritis: A Prospective Cohort Study. https://pubmed.ncbi.nlm.nih.gov/38710093/