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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.

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Journal ArticleDOI

Large-vessel giant cell arteritis: diagnosis, monitoring and management

TL;DR: Recent data suggest that biologic therapies, such as tocilizumab, may be effective and safe steroid-sparing options for patients with GCA, however, data specifically evaluating the management of LV-GCA are limited.
Journal ArticleDOI

Ultrasound in the diagnosis and management of giant cell arteritis.

Wolfgang A. Schmidt
- 01 Feb 2018 - 
TL;DR: The advantage of US over other imaging techniques in GCA is its availability, safety and tolerability and its high resolution of 0.1 mm.
References
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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

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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