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Related Experiment Videos

Does this patient have temporal arteritis?

Gerald W Smetana1, Robert H Shmerling

  • 1Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA.

JAMA
|January 12, 2002
PubMed
Summary
This summary is machine-generated.

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Diagnosing temporal arteritis (TA) is crucial to prevent vision loss. Jaw claudication and diplopia increase TA suspicion, while a normal erythrocyte sedimentation rate (ESR) makes TA unlikely.

Area of Science:

  • Rheumatology
  • Internal Medicine
  • Diagnostic Accuracy

Background:

  • Accurate diagnosis of temporal arteritis (TA) is vital to prevent irreversible visual loss.
  • Diagnostic value of specific signs and symptoms in suspected TA remains unclear.

Purpose of the Study:

  • To assess the diagnostic accuracy of historical features, physical examination, and erythrocyte sedimentation rate (ESR) for TA.

Main Methods:

  • Systematic literature review of English-language articles (1966-2000) and bibliography searches.
  • Inclusion of 41 studies, with 21 core studies featuring both biopsy-positive and biopsy-negative patients.
  • Independent data abstraction and quality assessment by two authors.

Main Results:

Related Experiment Videos

  • Jaw claudication (LR+, 4.2) and diplopia (LR+, 3.4) significantly increased TA likelihood in referred patients.
  • Temporal artery beading (LR+, 4.6), prominence (LR+, 4.3), and tenderness (LR+, 2.6) were predictive physical findings.
  • A normal ESR value strongly decreased the likelihood of TA (LR- for abnormal ESR, 0.2).

    • Conclusions:

    • Specific clinical features aid in predicting positive temporal artery biopsy results for suspected TA.
    • A normal ESR is the most useful indicator, making TA diagnosis less likely.