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Abstract Number: 2351

Correlation Between Hypoechoic Halo of the Temporal Arteries and Clinical, Laboratory, and Temporal Artery Biopsy Findings in Patients with Giant Cell Arteritis

Luigi Boiardi1, Giulia Pazzola2, Alberto Cavazza3, Francesco Muratore2, Giovanna Restuccia2, Alberto Nicolini4, Giuseppe Germanò2, Nicolo Pipitone2, Pierluigi Macchioni2, Niccolò Possemato2, Gianluigi Bajocchi5, Ilaria Padovano2, Olga Addimanda6, Alberto Lo Gullo2, Maria Grazia Catanoso7 and Carlo Salvarani8, 1Rheumatology service, Arcispedale S Maria Nuova, IRCCS, Reggio Emilia, Italy, 2Rheumatology Service, Arcispedale S Maria Nuova, IRCCS, Reggio Emilia, Italy, 3Pathology Unit, Arcispedale S Maria Nuova, Reggio Emilia, Italy, 4Internal Medicine, Arcispedale S Maria Nuova, IRCCS, Reggio Emilia, Italy, 5Department of Internal Medicine, Rheumatology Unit, Arcispedale S Maria Nuova. IRCCS, Reggio Emilia, Italy, 6Rheumatolgy Service, Arcispedale S Maria Nuova, IRCCS, Reggio Emilia, Italy, 7Rheumatology Service, Arcispedale S Maria Nuova, Reggio Emilia, Italy, 8Rheumatology, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: Temporal arteritis and ultrasound

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Session Information

Session Title: Vasculitis

Session Type: Abstract Submissions (ACR)

Background/Purpose: The presence of a hypoechoic halo of the temporal arteries on Color-Doppler sonography (CDS) has high specificity and acceptable sensitivity for the diagnosis of giant cell arteritis (GCA). However, it is unclear whether patients with a positive halo sign differ from those without such a sign. The aim of our study was to evaluate the correlations between the presence of a hypoechoic halo, on the one hand, and clinical, laboratory, and histological parameters, on the other, in patients with biopsy-proven GCA.

Methods: We analyzed the clinical records of 105 consecutive patients with biopsy-proven GCA (including those with transmural cell infiltration, small-vessel vasculitis and vasa vasorum vasculitis of the temporal arteries) who underwent CDS of the temporal arteries before temporal artery. Mean age was 74±8 years, while females were 72.4%. A hypoechoic halo larger than 0.4 mm around the temporal artery lumen on CDS was considered positive. Correlations were sought by chi-square test or Fisher’s exact test as appropriate using SPSS version 18.0.

Results: The presence of a hypoechoic halo significantly correlated with jaw claudication (58.8% vs 25.9%; p=0.001, odds ratio [OR] 4.1, 95% confidence interval [CI] 1.8-9.3), abnormalities of temporal artery on clinical examination (67.3% vs 46,9; p=0.041, OR 2.3  [CI 1.0-5.3]), elevated erythrocyte sedimentation rate [91.5% vs 59.2%; p=0.001, OR 7.4 [CI 2.3-23.94], and the presence of giant cells on temporal artery biopsy [66.7% vs 29.4%; p=0.0001, OR 4.8 [CI 2.0-11.4]. In addition, patients with a hypoechoic halo had higher levels of  blood platelets (396875 +116274 vs 327954 + 103181; p= 0.005, unpaired two-tailed t-test). However, no correlation was found between the presence of a ultrasonographic halo and visual loss.

Conclusion: These provide evidence for a close correlation between the presence of a hypoechoic halo on CDS of the temporal arteries and jaw claudication, giant cells on temporal artery biopsies, and elevated levels of erythrocyte sedimentation rate in patients with GCA. In contrast, a positive halo sign did not predict visual loss.


Disclosure:

L. Boiardi,
None;

G. Pazzola,
None;

A. Cavazza,
None;

F. Muratore,
None;

G. Restuccia,
None;

A. Nicolini,
None;

G. Germanò,
None;

N. Pipitone,
None;

P. Macchioni,
None;

N. Possemato,
None;

G. Bajocchi,
None;

I. Padovano,
None;

O. Addimanda,
None;

A. Lo Gullo,
None;

M. G. Catanoso,
None;

C. Salvarani,
None.

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