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

Coath, Fiona L. and Mukhtyar, Chetan (2021) Ultrasonography in the diagnosis and follow-up of giant cell arteritis. Rheumatology, 60 (6). 2528–2536. ISSN 1462-0324

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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.

Item Type: Article
Additional Information: © The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Uncontrolled Keywords: colour doppler ultrasonography,giant cell arteritis,rheumatology,pharmacology (medical) ,/dk/atira/pure/subjectarea/asjc/2700/2745
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Depositing User: LivePure Connector
Date Deposited: 28 Jul 2021 00:42
Last Modified: 06 Sep 2021 00:05
URI: https://ueaeprints.uea.ac.uk/id/eprint/80845
DOI: 10.1093/rheumatology/keab179

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