The use of temporal artery ultrasound in the diagnosis of giant cell arteritis in routine practice

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dc.contributor.authorBlack, R.
dc.contributor.authorRoach, D.
dc.contributor.authorRischmueller, M.
dc.contributor.authorLester, S.
dc.contributor.authorHill, C.
dc.date.issued2013
dc.descriptionArticle first published online: 8 JUN 2013
dc.description.abstractAim: 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.
dc.description.statementofresponsibilityRachel Black, Denise Roach, Maureen Rischmueller, Susan L. Lester and Catherine L. Hill
dc.identifier.citationInternational Journal of Rheumatic Diseases, 2013; 16(3):352-357
dc.identifier.doi10.1111/1756-185X.12108
dc.identifier.issn1756-1841
dc.identifier.issn1756-185X
dc.identifier.orcidBlack, R. [0000-0001-6600-7430]
dc.identifier.orcidRoach, D. [0000-0002-7242-4561]
dc.identifier.orcidRischmueller, M. [0000-0001-5057-3286]
dc.identifier.orcidHill, C. [0000-0001-8289-4922]
dc.identifier.urihttp://hdl.handle.net/2440/85717
dc.language.isoen
dc.publisherWiley-Blackwell Publishing Asia
dc.rights© 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd
dc.source.urihttps://doi.org/10.1111/1756-185x.12108
dc.subjectClinical practice; diagnosis; giant cell arteritis; temporal artery ultrasound
dc.titleThe use of temporal artery ultrasound in the diagnosis of giant cell arteritis in routine practice
dc.typeJournal article
pubs.publication-statusPublished

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