Temporal arteritis other diagnostic studies: Difference between revisions
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**Granulomas containing multinucleated histiocytic and foreign body giant cells, helper T-cell lymphocytes, plasma cells, and fibroblasts (7) | **Granulomas containing multinucleated histiocytic and foreign body giant cells, helper T-cell lymphocytes, plasma cells, and fibroblasts (7) | ||
*A positive temporal artery biopsy is diagnostic of temporal arteritis with a specificity of 100% and a sensitivity as low as 15% to as high as 87%.[117] | *A positive temporal artery biopsy is diagnostic of temporal arteritis with a specificity of 100% and a sensitivity as low as 15% to as high as 87%.[117] | ||
* | *Clinical features of severity correlate with the histopathological changes on the temporal artery biopsy.[11] | ||
*A positive biopsy after initiation of steroid treatment vary from 10% after 1 week to 86% after 4 or more weeks of treatment.[118, 119] | *A positive biopsy after initiation of steroid treatment vary from 10% after 1 week to 86% after 4 or more weeks of treatment.[118, 119] | ||
*Most physicians with high clinical suspicion despite an initial negative biopsy would still recommend a second contralateral biopsy, given the consequences of a missed diagnosis of temporal arteritis.[124] | *Most physicians with high clinical suspicion despite an initial negative biopsy would still recommend a second contralateral biopsy, given the consequences of a missed diagnosis of temporal arteritis.[124] | ||
* | *Risks of temporal artery biopsy are temporary or permanent damage to the temporal branch of the facial nerve, infection, bleeding, hematoma, and dehiscence. | ||
==References== | ==References== | ||
Revision as of 18:00, 8 April 2018
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Temporal Arteritis Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]
Overview
The gold standard for diagnosing temporal arteritis is biopsy, which involves removing of a small part of the vessel and examining it microscopically for giant cells infiltrating the tissue. Since the blood vessels are involved in a patchy pattern, there may be unaffected areas on the vessel and the biopsy might have been taken from these parts. So, a negative result does not definitely rule out the diagnosis.
[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies
- Temporal artery biopsy may be helpful in the diagnosis of temporal arteritis. Findings diagnostic of temporal arteritis include:[118][135]
- Skip lesions and normal intervening segments
- Intimal thickening, with prominent cellular infiltration
- Lymphocytes in the internal or external elastic lamina or adventitia
- Areas of necrosis may be present in the arterial wall
- Granulomas containing multinucleated histiocytic and foreign body giant cells, helper T-cell lymphocytes, plasma cells, and fibroblasts (7)
- A positive temporal artery biopsy is diagnostic of temporal arteritis with a specificity of 100% and a sensitivity as low as 15% to as high as 87%.[117]
- Clinical features of severity correlate with the histopathological changes on the temporal artery biopsy.[11]
- A positive biopsy after initiation of steroid treatment vary from 10% after 1 week to 86% after 4 or more weeks of treatment.[118, 119]
- Most physicians with high clinical suspicion despite an initial negative biopsy would still recommend a second contralateral biopsy, given the consequences of a missed diagnosis of temporal arteritis.[124]
- Risks of temporal artery biopsy are temporary or permanent damage to the temporal branch of the facial nerve, infection, bleeding, hematoma, and dehiscence.