Giant Cell Arteritis (GCA) Flashcards
What is the most common symptom of GCA?
Headache (72%) which is often located at the temple and occipital region.
What symptom has high specificity but low sensitivity for GCA?
Jaw claudication
What arteries can demonstrate abnormalities in GCA?
The superficial temporal artery (STA), occipital, posterior auricular or facial arteries demonstrate thickening, nodularity, tenderness or erythema.
What percentage of biopsy-proven GCA cases may have a normal ESR?
The ESR may be normal in 22.5 % of biopsy proven GCA cases.
What is the sensitivity and specificity of the halo sign on temporal (+/- axillary artery) US?
In good hands, the demonstration of a dark halo around the artery has revealed a sensitivity of 77 % and a specificity of 96%. The demonstration of bilateral dark halos seems to correlate well with development of ischemic complications in GCA, and has in experienced hands, a good correlation with biopsy proven GCA.
What is the minimum segment length of superficial temporal artery to obtain to get a good result when investigating for GCA?
When doing a biopsy to investigate for GCA it is important to obtain a sufficient segment of STA (commonly more than 2 cm). The histopathological changes in the temporal arteries include luminal stenosis, intimal proliferation and disruption of internal elastic lamina by a mononuclear cell infiltrate. The involvement is typically patchy (‘skip lesions’).
What is the clinical relevance / prognostic relevance of biopsy-negative GCA?
Patients of suspected GCA, who have typical symptoms of GCA, but are biopsy negative, are described to have less constitutional symptoms, less arterial wall abnormality and have lower chances of ischemic complications, as compared to biopsy positive cases.
