Temporal arteritis other diagnostic studies

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]
• The histopathological changes on TAB often correlate with clinical features of severity. [11]

• A positive biopsy after initiation of steroid treatment vary from only 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]

• Temporal artery biopsy is a safe procedure; however, risks include temporary or permanent damage to the temporal branch of the facial nerve, infection, bleeding, hematoma, and dehiscence.

• Other diagnostic studies for [disease name] include:
  • [Diagnostic study 1], which demonstrates:
    • [Finding 1]
    • [Finding 2]
    • [Finding 3]