Temporal arteritis other diagnostic studies: Difference between revisions
Hamid Qazi (talk | contribs) |
Hamid Qazi (talk | contribs) No edit summary |
||
| Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
The [[Gold standard (test)|gold standard]] for diagnosing temporal arteritis is [[biopsy]], which involves removing of a small part of the vessel and examining it [[microscope|microscopically]] for giant cells infiltrating the tissue. Since the [[blood vessel]]s are involved in a patchy pattern, there may be unaffected areas on the vessel and the biopsy might have been taken from these parts. So, a [[false negative|negative result]] does not definitely rule out the diagnosis | The [[Gold standard (test)|gold standard]] for diagnosing temporal arteritis is [[biopsy]], which involves removing of a small part of the vessel and examining it [[microscope|microscopically]] for giant cells infiltrating the tissue. Since the [[blood vessel]]s are involved in a patchy pattern, there may be unaffected areas on the vessel and the biopsy might have been taken from these parts. So, a [[false negative|negative result]] does not definitely rule out the diagnosis. Findings diagnostic of temporal arteritis include skip lesions and normal intervening segments, intimal thickening, with prominent cellular infiltration, lymphocytes in the internal or external elastic lamina or adventitia, areas of necrosis may be present in the arterial wall, granulomas containing multinucleated histiocytic and foreign body giant cells, helper T-cell lymphocytes, plasma cells, and fibroblasts. Risks of temporal artery biopsy are temporary or permanent damage to the temporal branch of the facial nerve, infection, bleeding, hematoma, and dehiscence. | ||
==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
Revision as of 18:03, 8 April 2018
|
Temporal Arteritis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Temporal arteritis other diagnostic studies On the Web |
|
American Roentgen Ray Society Images of Temporal arteritis other diagnostic studies |
|
Risk calculators and risk factors for Temporal arteritis other diagnostic studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]
Overview
The gold standard for diagnosing temporal arteritis is biopsy, which involves removing of a small part of the vessel and examining it microscopically for giant cells infiltrating the tissue. Since the blood vessels are involved in a patchy pattern, there may be unaffected areas on the vessel and the biopsy might have been taken from these parts. So, a negative result does not definitely rule out the diagnosis. Findings diagnostic of temporal arteritis include skip lesions and normal intervening segments, intimal thickening, with prominent cellular infiltration, lymphocytes in the internal or external elastic lamina or adventitia, areas of necrosis may be present in the arterial wall, granulomas containing multinucleated histiocytic and foreign body giant cells, helper T-cell lymphocytes, plasma cells, and fibroblasts. Risks of temporal artery biopsy are temporary or permanent damage to the temporal branch of the facial nerve, infection, bleeding, hematoma, and dehiscence.
Other Diagnostic Studies
- Temporal artery biopsy may be helpful in the diagnosis of temporal arteritis. Findings diagnostic of temporal arteritis include:[118][135]
- Skip lesions and normal intervening segments
- Intimal thickening, with prominent cellular infiltration
- Lymphocytes in the internal or external elastic lamina or adventitia
- Areas of necrosis may be present in the arterial wall
- Granulomas containing multinucleated histiocytic and foreign body giant cells, helper T-cell lymphocytes, plasma cells, and fibroblasts (7)
- A positive temporal artery biopsy is diagnostic of temporal arteritis with a specificity of 100% and a sensitivity as low as 15% to as high as 87%.[117]
- Clinical features of severity correlate with the histopathological changes on the temporal artery biopsy.[11]
- A positive biopsy after initiation of steroid treatment vary from 10% after 1 week to 86% after 4 or more weeks of treatment.[118, 119]
- Most physicians with high clinical suspicion despite an initial negative biopsy would still recommend a second contralateral biopsy, given the consequences of a missed diagnosis of temporal arteritis.[124]
- Risks of temporal artery biopsy are temporary or permanent damage to the temporal branch of the facial nerve, infection, bleeding, hematoma, and dehiscence.