PT  - JOURNAL ARTICLE
AU  - MICHAEL CZIHAL
AU  - FEDERICO TATÒ
AU  - ANTJE RADEMACHER
AU  - PETER KUHLENCORDT
AU  - HENDRIK SCHULZE-KOOPS
AU  - ULRICH HOFFMANN
TI  - Involvement of the Femoropopliteal Arteries in Giant Cell Arteritis: Clinical and Color Duplex Sonography
AID  - 10.3899/jrheum.110566
DP  - 2012 Feb 01
TA  - The Journal of Rheumatology
PG  - 314--321
VI  - 39
IP  - 2
4099  - http://www.jrheum.org/content/39/2/314.short
4100  - http://www.jrheum.org/content/39/2/314.full
SO  - J Rheumatol2012 Feb 01; 39
AB  - Objective. To determine the extent and clinical significance of giant cell arteritis (GCA) of the femoropopliteal arteries. Methods. This was a retrospective clinical color duplex sonography (CDS) study; 60 of 112 consecutive patients with the diagnosis of GCA underwent complete clinical examination of the lower extremities including the vasculature, systolic ankle pressure measurement, and CDS scans of the femoropopliteal arteries within 1 year after diagnosis of GCA. Circumferential, hypoechogenic, homogenous wall thickening was regarded as a hallmark of femoropopliteal GCA. Results. GCA of femoropopliteal arteries was present in 32 (53.3%) of 60 patients. In general, femoropopliteal GCA developed bilaterally (100%) and 14 patients (23.3%) had significant lower extremity artery obstructions secondary to vasculitis, all leading to symptomatic lower extremity ischemia, with development of critical leg ischemia in 4 patients. Compared with subjects without lower extremity vasculitis, patients with femoropopliteal involvement had a significant time delay until diagnosis (mean 23.9 vs 11.1 weeks; p = 0.03) and a higher frequency of concomitant vasculitis of the arm arteries (74.2% vs 42.9%; p = 0.02). Conclusion. Femoropopliteal artery involvement appears to be a clinically relevant manifestation of GCA, frequently leading to symptomatic lower extremity ischemia. CDS of the femoropopliteal arteries is a noninvasive diagnostic tool for detection of lower extremity vasculitis in GCA.