Abstract

Does the aim justify the means when using a temporal artery biopsy to diagnose giant cell arteritis?

Author(s): Bowling K

Background Early temporal roadway vivisection is recommended in all cases with suspected cranial GCA (Giant Cell Arteritis) by the BSR (British Society of Rheumatology) and BHPR (British Health Professionals in Rheumatology) guidelines. This should be performed within one week immaculately. Aim To assess ACR (American College of Rheumatology) score at donation and whether temporal roadway vivisection affects clinical operation of the clinically suspected GCA case. Materials and methods Case records of all temporal roadway necropsies performed within January 2012 until December 2014 were analysed for size and result of vivisection and this was identified to clinical operation following result. Results 129 temporal highways were biopsied with a aggregate of 17 positive vivisection results. 10 vivisection samples were inadequate to confirm or refute GCA. 8 cases within the necropsies negative for GCA had their prednisolone remedy stopped. 5 cases had unknown follow up, with the remainder (89, 87.3) of the cases continued prednisolone operation for treatment of GCA for at least 6 weeks. Conclusions Overall13.2 of our necropsies was positive for GCA and87.3 of vivisection negative cases continued prednisolone remedy on clinical grounds. In the face of new individual tests (high resolution MRI (glamorous Resonance Imaging), colour duplex USS (Ultra Sound overlook) and PET (Positive Emission Topography) can we justify invasive surgery to all cases on histological grounds when the results may not alter operation? farther disquisition is demanded directly comparing newer imaging modalities to histology