[Is the biopsy of the temporal artery necessary? A study of 204 biopsies]

Due to the controversy on the need of performing temporal artery biopsies for the diagnosis of giant cell arteritis (GCA), we have reviewed 204 biopsies of temporal arteries as well as the clinical histories of the 190 patients. Patients without local manifestations were excluded from this study. From the 173 remaining patients, 54 presented a diagnostic biopsy of GCA. The 119 patients with a negative biopsy were divided into different groups according to the final diagnosis. From our data we could not find a clinical pattern which could permit the prediction of biopsy positiveness. We could not find either any clinical entity in the nondiagnostic group which would permit to exclude a diagnosis before performing the biopsy. We consider that the biopsy of the temporal artery can not be avoided nowadays and that it represents the only decisive diagnostic method of GCA.