ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2672

Ultrasonography in the Diagnosis of Giant Cell Arteritis

ROK JESE 1, Ziga Rotar 1, Matija Tomšič 2 and Alojzija Hocevar3, 1UMC LJUBLJANA, DPT. OF RHEUMATOLOGY, LJUBLJANA, Slovenia, 2Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, LJUBLJANA, Slovenia, 3Department of Rheumatology, University Medical Center Ljubljana, Slovenia, LJUBLJANA, Slovenia

Meeting: 2019 ACR/ARP Annual Meeting

Keywords:

Session Information

Date: Tuesday, November 12, 2019

Title: Vasculitis – Non-ANCA-Associated & Related Disorders Poster III: Giant Cell Arteritis

Session Type: Poster Session (Tuesday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Imaging has been recently recognized as a tool equivalent to the temporal artery biopsy in diagnosing giant cell arteritis (GCA). Amongst a variety of imaging modalities, color Doppler Ultrasonography (CDS) is the most convenient. We aimed to evaluate the frequency of cranial- and aortic arch-artery involvement in GCA using CDS.

Methods: We performed CDS examination of cranial and aortic arch arteries in new, clinically diagnosed GCA patients between October 2013 and April 2019, using a Philips IU22 with 5–17.5 MHz linear probe or Philips Epiq 7 with 5–18.5 MHz linear probe. Temporal, facial, occipital, thyroid, carotid, vertebral, subclavian, and axillary arteries were examined bilaterally. A halo with positive compression sign was considered a positive finding. Additionally, the thickness of intima-media complex was measured. .

Results: During the 67-month period 212 newly diagnosed GCA patients (63.2% females, median (IQR) age 75.4 (67.2-80.8) years) underwent vascular CDS evaluation. CDS was performed prior to glucocorticoid initiation in 201 patients (94.8%), and delayed by a median (IQR) of 1 (1-3) days (range 1-6 days) for the rest.

The CDS was positive in 208 (98.1%) patients in at least one of the examined arteries. Temporal arteries, involved in 167 (78.8%) patients, were the most commonly affected vessels. Extracranial large vessel involvement (LVV) was found in 70 (33.0%) patients (30 patients had isolated LVV, and 40 concomitant temporal artery involvement). Among the 142 patients without LVV, 11(5.2% of the studied cohort) had involvement of cranial arteries other than temporal arteries (we found facial, occipital and thyroid artery involvement in 9, 3 and 2 patients, respectively). Table 1 shows the frequency of individual vessel involvement and the intima-media thickness of inflamed and non-inflamed arteries.

Conclusion: CDS of eight preselected cranial and aortic arch arteries provides a high diagnostic yield in GCA.

Table 1. Involvement of cranial and aortic arch arteries in GCA assessed by CDS

Disclosure: R. JESE, None; Z. Rotar, AbbVie, 9, Amgen, 5, 8, Eli-Lilly, 9, MSD, 5, Novartis, 9, Pfizer, 9, Sanofi, 5; M. Tomšič, None; A. Hocevar, None.

To cite this abstract in AMA style:

JESE R, Rotar Z, Tomšič M, Hocevar A. Ultrasonography in the Diagnosis of Giant Cell Arteritis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/ultrasonography-in-the-diagnosis-of-giant-cell-arteritis/. Accessed .

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