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https://hdl.handle.net/2440/85717
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Type: | Journal article |
Title: | The use of temporal artery ultrasound in the diagnosis of giant cell arteritis in routine practice |
Author: | Black, R. Roach, D. Rischmueller, M. Lester, S. Hill, C. |
Citation: | International Journal of Rheumatic Diseases, 2013; 16(3):352-357 |
Publisher: | Wiley-Blackwell Publishing Asia |
Issue Date: | 2013 |
ISSN: | 1756-1841 1756-185X |
Statement of Responsibility: | Rachel Black, Denise Roach, Maureen Rischmueller, Susan L. Lester and Catherine L. Hill |
Abstract: | Aim: The exact diagnostic role of temporal artery ultrasound (TAU) remains unclear. The aim of this study was to determine the sensitivity and specificity of a positive halo sign in patients undergoing TAU in a clinical setting, and to perform a review of existing evidence. Method: Patients who had undergone TAU at a single centre in Australia were included in the study. The presence or absence of a halo sign and whether it was unilateral or bilateral was determined retrospectively from radiology reports. Pathology results were used to determine which patients underwent a temporal artery biopsy and if the biopsy was positive or negative. A case note review was performed to determine presenting clinical features and if a clinical diagnosis of giant cell arteritis was made. The sensitivity, specificity and likelihood ratios of TAU compared to both biopsy and clinical diagnosis were calculated. Results: Fifty patients were identified as having had a TAU (28% male, mean age 69). When compared to biopsy-proven cases, the sensitivity of a halo sign was 40%, specificity 81%, positive likelihood ratio 2.1 and negative likelihood ratio 0.7. When compared to clinical diagnosis, the sensitivity was 42%, specificity 94%, positive likelihood ratio 7.1 and negative likelihood 0.6. Conclusions: Sensitivity and specificity results were comparable to the literature. A halo sign may preclude the need for biopsy in cases of high clinical suspicion and contraindications to surgery. Biopsy remains necessary in most cases, irrespective of whether a halo sign is present. |
Keywords: | Clinical practice; diagnosis; giant cell arteritis; temporal artery ultrasound |
Description: | Article first published online: 8 JUN 2013 |
Rights: | © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd |
DOI: | 10.1111/1756-185X.12108 |
Published version: | http://dx.doi.org/10.1111/1756-185x.12108 |
Appears in Collections: | Aurora harvest 2 Surgery publications |
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