Can Ultrasound Replace Temporal Artery Biopsy for Diagnosing Giant Cell Arteritis?

Abstract

Giant cell arteritis (GCA) is one of the most feared diagnoses for neuro ophthalmologists, eye care providers in general, rheumatologists, and primary care providers. Treatment for GCA typically requires a long duration of immunosuppressive therapy, which carries the risk of shortterm and long-term side effects. These side effects can be particularly debilitating in the affected elderly population. Therefore, the goal of diagnostic testing for GCA is to secure the diagnosis with as high a level of confidence as possible, to justify the potential risks of long-term treatment. In the past, temporal artery biopsy (TAB) has been the gold standard for diagnosis. More recently, temporal artery ultrasonography (TAU) has emerged as a potential alternative, with more convenience and lower cost. Two authors debate whether temporal artery ultrasound can replace temporal artery biopsy.