What is it about?
Giant cell arteritis (GCA) is an autoimmune disease of the blood vessels in the elderly that can cause lack of blood flow to various parts of the body, especially the eyes, with resultant blindness. The traditional "gold standard" test to confirm the clinical suspicion of GCA is a temporal artery biopsy, but this requires a 45 minute procedure and a scalp wound. As of late ultrasound has been increasingly proposed as a substitute for temporal artery biopsy. It is important to confirm the diagnosis of GCA, because the treatment of GCA is glucocorticoids (steroids) which have many potential side effects. European physicians seem to prefer ultrasound more than temporal artery biopsy. More than ninety percent of North American ophthalmologists, neurologists and rheumatologists in Ontario, Canada prefer a temporal artery biopsy.
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Why is it important?
In some areas it is may be difficult to obtain a temporal artery biopsy. Temporal artery biopsy is an invasive procedure. In order to obtain a specimen that is of adequate length, surgeons require appropriate training. Ultrasound is non-invasive, can be performed serially, and can also image other blood vessels in addition to the temporal artery. However ultrasound is also very dependent on the skill and experience of the operator. Also, on ultrasound other conditions such as atherosclerosis can give the false impression of GCA.
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This page is a summary of: Practice Preferences: Temporal Artery Biopsy versus Doppler Ultrasound in the Work-Up of Giant Cell Arteritis, Neuro-Ophthalmology, October 2019, Taylor & Francis, DOI: 10.1080/01658107.2019.1656752.
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