Diagnosing giant cell arteritis: a comprehensive practical guide for the practicing rheumatologist.

Area of Science:

• Rheumatology
• Internal Medicine
• Vascular Medicine

Background:

• Giant cell arteritis (GCA) is the most prevalent large vessel vasculitis in older adults.
• Advanced imaging techniques have significantly impacted GCA diagnosis.
• The fast-track clinic model, integrating ultrasound, enables rapid and accurate GCA diagnosis and treatment.

Purpose of the Study:

• To review current evidence on diagnosing GCA.
• To propose a simplified diagnostic algorithm for GCA.
• To support rheumatologists outside specialist centers in diagnosing GCA.

Main Methods:

• Review of current literature on GCA diagnostic modalities.
• Development of a straightforward diagnostic algorithm for GCA.
• Focus on ultrasound (US) as a key diagnostic tool.

Main Results:

• Fast-track clinics with US improve GCA prognosis and are cost-effective.
• Diagnostic accuracy of imaging modalities is operator-dependent.
• A need exists for accessible diagnostic tools in non-specialist settings.

Conclusions:

• A simple GCA diagnostic algorithm can aid rheumatologists in resource-limited settings.
• Integrating ultrasound into fast-track clinics is effective for GCA diagnosis.
• Standardizing diagnostic approaches can improve patient outcomes for GCA.