@article {Maldinijrheum.100353, author = {Carla Maldini and Caroline D{\'e}pinay-Dhellemmes and Thi T.S. Tra and Michel Chauveau and Yannick Allanore and Laure Gossec and Genevi{\`e}ve Terrasse and Lo{\"\i}c Guillevin and Jo{\"e}l Coste and Alfred Mahr}, title = {Limited Value of Temporal Artery Ultrasonography Examinations for Diagnosis of Giant Cell Arteritis: Analysis of 77 Subjects}, elocation-id = {jrheum.100353}, year = {2010}, doi = {10.3899/jrheum.100353}, publisher = {The Journal of Rheumatology}, abstract = {Objective Use of TA-US for diagnostic investigation of giant cell arteritis (GCA) has been proposed but remains a matter of debate because of the heterogeneous findings. We retrospectively evaluated operating characteristics of temporal artery ultrasonography (TA-US) in a single teaching hospital. Methods All subjects with suspected GCA had been seen between 2002 and 2008 and had undergone TA-US with continuous-wave Doppler (until 2004) or color duplex ultrasonography (after 2004), followed within 30 days by a temporal artery biopsy (TAB). TA-US findings were compared with TAB-proven GCA and clinically diagnosed GCA. Results are expressed as sensitivities, specificities, and positive (LR+) and negative likelihood ratios (LR{\textendash}) of stenoses, occlusions, and the halo sign; for the latter, only color duplex TA-US was considered. Results Seventy-seven patients fulfilled the selection criteria; 13 had TAB-proven and 19 had clinically defined GCA. Stenoses/occlusions were seen on 45.5\% of TA-US and the halo sign was seen only once (3.2\%) in 31 duplex TA-US. Respective sensitivities, specificities, LR+, and LR{\textendash} for GCA diagnosis (using TAB-proven/clinically defined GCA as reference standards) were 69\%/53\%, 59\%/57\%, 1.7/1.2, and 0.5/0.8 for stenoses and/or occlusions, and 17\%/10\%, 100\%/100\%, infinite/infinite, and 0.8/0.9 for the halo sign. Conclusion The halo sign showed 100\% specificity for GCA but only 10\%{\textendash}17\% sensitivity. Stenoses/occlusions were of low diagnostic value. These observations suggest that TA-US is neither an effective substitute for TAB nor a reliable screening test to decide which patients can be safely spared TAB.}, issn = {0315-162X}, URL = {https://www.jrheum.org/content/early/2010/08/29/jrheum.100353}, eprint = {https://www.jrheum.org/content/early/2010/08/29/jrheum.100353.full.pdf}, journal = {The Journal of Rheumatology} }