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Subclavian artery involvement in patients with giant cell arteritis: do we need a modified Halo Score?

Juan Molina Collada1,2, Julia Martínez-Barrio3,4, Belén Serrano-Benavente3,4

  • 1Department of Rheumatology, Hospital General Universitario Gregorio Marañón, Calle del Dr. Esquerdo, 46, 28007, Madrid, Spain. molinacolladajuan@gmail.com.

Clinical Rheumatology
|January 12, 2021
PubMed

Insights

Adding subclavian artery ultrasound to the Southend Halo Score does not improve giant cell arteritis (GCA) diagnosis. However, the modified Halo Score better reflects inflammation in large vessel GCA, suggesting a role in monitoring disease activity.

Area of Science:

  • Rheumatology
  • Vascular Ultrasound
  • Diagnostic Accuracy

Background:

  • Giant cell arteritis (GCA) is a vasculitis affecting large arteries.
  • Ultrasound (US) is a key diagnostic tool for GCA.
  • Current scoring systems, like the Southend Halo Score, assess US findings.

Purpose of the Study:

  • To evaluate if including subclavian artery assessment in the modified Halo Score enhances GCA diagnostic accuracy.
  • To determine the relationship between the modified Halo Score and systemic inflammation markers.

Main Methods:

  • Retrospective study of patients on a GCA fast track pathway.
  • US examination of temporal and large vessels (carotid, subclavian, axillary arteries).
  • Assessment using halo count, Southend Halo Score, and modified Halo Score; GCA diagnosis confirmed clinically.

Main Results:

  • Subclavian artery involvement was specific to GCA patients.
  • All three scores demonstrated excellent diagnostic accuracy (ROC AUC > 0.90).
  • The modified Halo Score showed a better correlation with inflammatory markers in large vessel GCA.

Conclusions:

  • The modified Halo Score, including subclavian arteries, does not improve GCA diagnostic accuracy.
  • It better correlates with systemic inflammation markers in large vessel GCA.
  • May aid in monitoring disease activity in large vessel GCA.
Abstract

Keywords:
Giant cell arteritisHalo countHalo scoreHalo signUltrasound

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