Diagnostic performance of colour duplex ultrasonography along with temporal artery biopsy in suspicion of giant cell arteritis.
OBJECTIVE
Giant cell arteritis (GCA) is a vasculitis that occurs in older adults, affecting vessels of medium and large caliber. GCA diagnosis is a challenge for general practitioners and specialists. The aim of this study was to retrospectively analyse performances of temporal artery biopsy (TAB) and colour duplex ultrasonography (CDU) for GCA diagnosis.


METHODS
All patients with suspicion of GCA and who underwent both TAB and CDU between April 2009 and March 2014 were included in the study. A positive CDU examination was defined by halos on both superficial temporal arteries. Patients were classified based on the physician final diagnosis.


RESULTS
Among the 42 eligible patients, 12 had an alternative diagnosis and 30 were diagnosed with GCA. Sensitivities were 77% and 80% for TAB and CDU examinations, respectively. Specificities were 100% for both tests. Twenty-nine (96.7%) patients with GCA had their diagnosis confirmed either by CDU and/or by TAB. Time lengths between the first medical examination and results of TAB and CDU were 15 and 4.2 days (p<0.001), respectively.


CONCLUSIONS
Our study suggests that in suspected GCA, CDU may be used as first line examination followed by TAB in case of CDU negative results. Such algorithm needs to be further assessed in a multicentre prospective study.
Angiology Department, Groupe Hospitalier de la Rochelle Ré Aunis, La Rochelle, France.
Christophe
C
Roncato
Clinical Research Unit, Groupe Hospitalier de la Rochelle Ré Aunis, La Rochelle, France.
Caroline
C
Allix-Béguec
Internal Medicine Department, Groupe Hospitalier de la Rochelle Ré Aunis, La Rochelle, France.
Elisabeth
E
Brottier-Mancini
Rheumatology Department, Groupe Hospitalier de la Rochelle Ré Aunis, La Rochelle, France.
Bruno
B
Gombert
Internal Medicine and Haematology Department, Centre Hospitalier de Rochefort, France. guillaume.denis@ch-rochefort.fr.
Guillaume
G
Denis
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005260:Female; D013700:Giant Cell Arteritis / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013699:Temporal Arteries / Q000000981:diagnostic imaging* / Q000473:pathology*; D018615:Ultrasonography, Doppler, Color