Performance of Diagnostic Examinations for Giant Cell Arteritis and Subtypes: A Multicenter Japanese Study
Nobuhiro Oda1, Sho Fukui2,3,4, Fumika N Nagase5
1Department of Rheumatology and Allergy, Kameda Medical Center, Chiba, Japan.
International Journal of Rheumatic Diseases
|December 19, 2025
Summary
Diagnosing giant cell arteritis (GCA) in Japan is complex. Combining temporal artery ultrasound (TAU) with MRI and biopsy may improve cranial GCA detection.
Area of Science:
- Rheumatology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Giant cell arteritis (GCA) is a systemic vasculitis affecting large arteries.
- Accurate diagnosis of GCA, particularly cranial GCA (C-GCA) and large vessel GCA (LV-GCA), is crucial for timely treatment.
- Diagnostic approaches vary, impacting patient outcomes.
Purpose of the Study:
- To elucidate the diagnostic process for GCA subtypes in Japan.
- To evaluate the diagnostic performance of various imaging modalities for GCA.
- To assess the concordance between temporal artery ultrasound (TAU) and temporal artery biopsy (TAB).
Main Methods:
- Secondary analysis of a multicenter retrospective study of GCA patients treated with tocilizumab.
- Classification of patients into C-GCA and LV-GCA based on clinical and imaging findings.
- Evaluation of diagnostic performance of TAU, TAB, MRI, CT, and PET-CT.
Main Results:
- Temporal artery ultrasound (TAU) showed low sensitivity for C-GCA (52.6%).
- Temporal artery biopsy (TAB) had higher positivity rates (81.8%) for C-GCA.
- PET-CT demonstrated 100% positivity for LV-GCA, while CT showed 81.5% positivity.
- Concordance between TAU and TAB varied significantly across institutions.
Conclusions:
- Temporal artery ultrasound (TAU) has limited sensitivity for diagnosing cranial GCA in Japan.
- Combining TAU with head MRI and TAB may enhance GCA diagnosis in Japanese clinical practice.
- Institutional variability in TAU performance necessitates careful interpretation.
More Related Videos
04:50Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain
Published on: May 16, 2025
778
07:25Author Spotlight: A Focus on Standardized Salivary Gland Ultrasound Protocol in Connective Tissue Disease Research
Published on: October 13, 2023
4.9K
Related Concept Videos
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
443
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
443
01:30Acute Coronary Syndrome III: Diagnostic Studies
197
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
197
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
218
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
218
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
434
Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
434
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
318
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
318
01:27Myocarditis II: Clinical Features and Diagnostic Tests
236
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
236