Use of ultrasound in diagnosis of giant cell arteritis (literature review and clinical case)

Abstract

Giant cell arteritis (GCA) is the most common primary systemic vasculitis that usually occurs in adults over the age of 50. According to the classification, GCA refers to vasculitis with damage to large vessels (aorta and/or its main branches), however, both medium and small arteries can be involved in the process. Typical is the involvement of the temporal, visual, occipital, vertebrate, posterior ciliary arteries. Temporal artery biopsy has been considered as the ’gold standard’ for the diagnosis of GCA for a long time. However, this procedure is not always feasible in real clinical practice, because of the invasiveness of the method and certain technical difficulties. Currently, the cheapest, fastest and safest way to diagnose GCA is ultrasonography (US) examination of arteries (temporal arteries, other cranial and extracranial arteries), which is included in the new classification criteria for GCA. Thanks to the wider use of US of the arteries, over the past few years, the diagnosis of GCA has significantly improved, which affects the adequacy of therapy positively and, therefore, the patient's long-term prognosis. Standardization of the examination procedure is important, and the analysis of US-images should be carried out by a qualified specialist, which also requires special training. The review presents the necessary technical requirements, characteristics of the equipment and the methodology for conducting a US-study, determining US-finds during GCA. Thus, a personalized approach to the diagnosis of GCA, based on clinical manifestations, available instrumental imaging methods (primarily ultrasound), is optimal for the rapid diagnosis of HCA and treatment.