Ultrasonography in the diagnosis and follow-up of giant cell arteritis

Fiona L. Coath, Chetan Mukhtyar

    Research output: Contribution to journalArticle

    Abstract

    Colour Doppler ultrasonography is the first measure to allow objective bedside assessment of GCA. This article discusses the evidence using the OMERACT filter. Consensus definitions for ultrasonographic changes were agreed upon by a Delphi process, with the 'halo' and 'compression' signs being characteristic. The halo is sensitive to change, disappearing within 2-4 weeks of starting glucocorticoids. Ultrasonography has moderate convergent validity with temporal artery biopsy in a pooled analysis of 12 studies including 965 participants [κ = 0.44 (95% CI 0.38, 0.50)]. The interobserver and intra-observer reliabilities are good (κ = 0.6 and κ = 0.76-0.78, respectively) in live exercises and excellent when assessing acquired images and videos (κ = 0.83-0.87 and κ = 0.88, respectively). Discriminant validity has been tested against stroke and diabetes mellitus (κ=-0.16 for diabetes). Machine familiarity and adequate examination time improves performance. Ultrasonography in follow-up is not yet adequately defined. Some patients have persistent changes in the larger arteries but these do not necessarily imply treatment failure or predict relapses.

    Original languageEnglish
    Pages (from-to)2528–2536
    Number of pages9
    JournalRheumatology
    Volume60
    Issue number6
    Early online date18 Feb 2021
    DOIs
    Publication statusPublished - Jun 2021

    Keywords

    • colour Doppler ultrasonography
    • giant cell arteritis

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