Ultrasound cut-off values for intima-media thickness of temporal, facial and axillary arteries in giant cell arteritis.
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TLDR
IMT measurement can correctly distinguish vasculitic from normal arteries in suspected GCA, with 100% sensitivities and specificities for common superficial temporal arteries, for frontal branches and for axillary arteries and sensitivities of 97.7 and 98.8% for parietal branches and facial arteries, respectively.Abstract:
Objective To evaluate the intima-media thickness (IMT) of arteries involved in GCA for determining cut-off values. Methods Forty newly diagnosed GCA patients in a fast-track GCA clinic and 40 age- and sex-matched controls were included. IMT measurement was performed at or within 24 h after diagnosis. The common superficial temporal arteries with their frontal and parietal branches and the facial arteries were bilaterally examined with a 10-22 MHz probe and the axillary artery with a 6-18 MHz probe. Receiver operating characteristics analysis was performed for estimating cut-off values. Results The mean age was 72 years (s.d. 9) and 68% were females. In the control group, IMT was 0.23 mm (s.d. 0.04), 0.19 mm (s.d. 0.03), 0.20 mm (s.d. 0.03), 0.24 mm (s.d. 0.05) and 0.59 mm (s.d. 0.10) for the common superficial temporal arteries, the frontal and parietal branches, the facial arteries and the axillary arteries, respectively. In vasculitic segments of GCA patients, IMT was 0.65 mm (s.d. 0.18), 0.54 mm (s.d. 0.18), 0.50 mm (s.d. 0.17), 0.53 mm (s.d. 0.16) and 1.7 mm (s.d. 0.41), respectively. Cut-off values are 0.42, 0.34, 0.29, 0.37 and 1.0 mm, respectively, with 100% sensitivities and specificities for common superficial temporal arteries, for frontal branches and for axillary arteries and sensitivities of 97.2 and 87.5% and specificities of 98.7 and 98.8% for parietal branches and facial arteries, respectively. The intraclass correlation coefficient was between 0.87 and 0.98. Conclusion IMT measurement can correctly distinguish vasculitic from normal arteries in suspected GCA.read more
Citations
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Definitions and reliability assessment of elementary ultrasound lesions in giant cell arteritis: a study from the OMERACT Large Vessel Vasculitis Ultrasound Working Group
Stavros Chrysidis,Christina Duftner,Christian Dejaco,Valentin S. Schäfer,Sofia Ramiro,Greta Carrara,Carlo Alberto Scirè,Alojzija Hočevar,Andreas P. Diamantopoulos,Annamaria Iagnocco,Chetan Mukhtyar,Cristina Ponte,Esperanza Naredo,Eugenio de Miguel,George A W Bruyn,Kenneth J. Warrington,Lene Terslev,Marcin Milchert,Maria Antonietta D'Agostino,Mattew J. Koster,Naina Rastalsky,Petra Hanova,Pierluigi Macchioni,Tanaz A. Kermani,Tove Lorenzen,Uffe Møller Døhn,Ulrich Fredberg,Wolfgang Hartung,Bhaskar Dasgupta,Wolfgang A. Schmidt +29 more
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Kornelis S M van der Geest,Frances Borg,Abdul Kayani,Davy Paap,Davy Paap,Prisca Gondo,Wolfgang A. Schmidt,Raashid Luqmani,Bhaskar Dasgupta +8 more
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References
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Journal ArticleDOI
The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis
Gene G. Hunder,Gene G. Hunder,Daniel A. Bloch,Daniel A. Bloch,Beat A. Michel,Mary Betty Stevens,Mary Betty Stevens,William P. Arend,William P. Arend,Leonard H. Calabrese,Leonard H. Calabrese,Steven M. Edworthy,Steven M. Edworthy,Anthony S. Fauci,Anthony S. Fauci,Randi Y. Leavitt,J. T. Lie,J. T. Lie,Robert W. Lightfoot,Robert W. Lightfoot,Alfonse T. Masi,Alfonse T. Masi,Dennis J. McShane,Dennis J. McShane,John A. Mills,John A. Mills,Stanley L. Wallace,Stanley L. Wallace,Nathan J. Zvaifler,Nathan J. Zvaifler +29 more
TL;DR: Criteria for the classification of giant cell (temporal) arteritis were developed by comparing 214 patients who had this disease with 593 patients with other forms of vasculitis, and 2 other variables were included: scalp tenderness and claudication of the jaw or tongue or on deglutition.
Journal ArticleDOI
Color Duplex Ultrasonography in the Diagnosis of Temporal Arteritis
TL;DR: In patients with typical clinical signs and a halo on ultrasonography, it may be possible to make a diagnosis of temporal arteritis and begin treatment without performing a temporal-artery biopsy.
Journal ArticleDOI
Polymyalgia Rheumatica and Giant Cell Arteritis: A Systematic Review
TL;DR: Current evidence regarding optimal methods for diagnosing and treating Polymyalgia rheumatica and giant cell arteritis is summarized to suggest glucocorticoids as the most effective therapy for PMR/GCA.
Journal ArticleDOI
The Role of Ultrasound Compared to Biopsy of Temporal Arteries in the Diagnosis and Treatment of Giant Cell Arteritis (TABUL): a diagnostic accuracy and cost-effectiveness study.
Raashid Luqmani,Ellen Lee,Surjeet Singh,M Gillett,Wolfgang A. Schmidt,Mike Bradburn,Bhaskar Dasgupta,Andreas P. Diamantopoulos,Wulf Forrester-Barker,William Hamilton,Shauna Masters,Brendan McDonald,Eugene McNally,Colin T. Pease,Jennifer Piper,John F Salmon,Allan Wailoo,Konrad Wolfe,Andrew Hutchings +18 more
TL;DR: The feasibility of providing training in ultrasound for the diagnosis of giant cell arteritis has been demonstrated and the results indicate better sensitivity but poorer specificity of ultrasound compared with biopsy and suggest some scope for reducing the role of biopsy.
Journal ArticleDOI
Giant-cell arteritis and polymyalgia rheumatica.
TL;DR: Neither headache nor visual symptoms developed when the glucocorticoids were tapered, and the diplopia resolved after 6 days of treatment with 60 mg of prednisone daily.
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