Temporal artery ultrasound, EULAR criteria reliable diagnostics for giant cell arteritis
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KIAWAH ISLAND, S.C. — Temporal artery ultrasound and EULAR score are reliable means for diagnosing giant cell arteritis, Mercy Bechtold, MD, said during her presentation at Kiawah Eye.
Ultrasound and EULAR classification criteria have the potential to avoid the need for biopsy, thus reducing health care costs and delays in diagnosis, she said.
A group of researchers at the Medical University of South Carolina reviewed the medical records of all patients suspected to have giant cell arteritis (GCA) who underwent a temporal artery ultrasound or temporal artery biopsy between December 2012 and December 2023. The EULAR score was then calculated for all patients using eight of the 10 classification criteria available. Of the 149 patients who met inclusion criteria, 127 had temporal artery biopsies, 70 had temporal artery ultrasounds, and 48 had both a biopsy and an ultrasound. Forty-seven patients were treated for GCA.
The majority of patients, whether they were treated for GCA or not, were female and white. Treated patients were older. The most common presenting symptoms were headache and visual changes, followed by jaw claudication, scalp tenderness and morning stiffness.
“We looked at the patients who had both an ultrasound and a biopsy done ... and most of the test results were concordant with each other,” Bechtold said.
Temporal artery biopsy had the highest specificity at 97.6%, “and this is why biopsy remains the gold standard for diagnosis,” she said. However, ultrasound also had a high specificity at 90.9%, indicating that there were few false positives.
A EULAR score of six or higher was associated with a high sensitivity for treatment for GCA, and a EULAR score less than six was associated with a high negative predictive value for not being treated for GCA.
“Our study indicates that temporal artery ultrasound and EULAR scores could be more widely used in the workup and diagnosis of giant cell arteritis,” Bechtold said.
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Bechtold M. Temporal artery ultrasound and EULAR criteria to diagnose giant cell arteritis. Presented at: Kiawah Eye; May 30-June 1, 2024; Kiawah Island, South Carolina.
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