Ultrasound in the diagnosis of giant cell arteritis

Giant cell arteritis (GCA) is a type of large vessel vasculitis, mostly involving branches of the external carotid artery, which commonly affects the arteries of the scalp and face but can affect any of the cranial branches arising from the arch of the aorta. It is potentially a very serious condition, which can cause blindness in up to a third of patients. It is therefore managed as a medical emergency within rheumatology. A timely and accurate diagnosis is essential to help prevent complications and allow the appropriate treatment to be commenced, including high dose steroids. Ultrasound is now commonly used as an adjunct to clinical assessment and this article will describe its place in the diagnosis of GCA.

Vasculitis is an inflammatory condition of the blood vessel walls. It can be due to infection or more commonly a primary inflammatory cause and affects the large, medium or small vessels. GCA is a non-infective type and the most common, affecting the large and medium vessels. Another less common vasculitis affecting the same vessels is Takayasu’s arteritis. The most common term for GCA is temporal arteritis, but other terms used to describe GCA include cranial arteritis, Horton’s arteritis or granulomatous arteritis.

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