Abstract
Giant Cell Arteritis (GCA) and Takayasu’s arteritis (TAK) involve predominantly the large vessels and may lead to ischaemic manifestations in the end organs or development of life-threatening aneurysms. GCA is mainly seen in individuals >50 years while TAK in individuals <40 years. Both diseases have a predilection for the aorta and the aortic tree, in addition, GCA involves the cranial arteries (temporal, facial, maxillary and occipital). European League against Rheumatism (EULAR) recommends ultrasound as a first-line evaluation in patients suspected to have GCA [1]. Ultrasound yields a high sensitivity and specificity in the diagnostics of GCA [2]. Ultrasound can be useful in diagnosing TAK, however, a major limitation being the non-visualization of the descending aorta (Dejaco et al. in Ann Rheum Dis. 77:636–643, 2018). Ultrasound is a highly operator-dependent modality and requires specialized skills.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Dejaco C, Ramiro S, Duftner C, Besson FL, Bley TA, Blockmans D, et al. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice. Ann Rheum Dis. 2018;77(5):636-43
Duftner C, Dejaco C, Sepriano A, Falzon L, Schmidt WA, Ramiro S. Imaging in diagnosis, outcome prediction and monitoring of large vessel vasculitis: a systematic literature review and meta-analysis informing the EULAR recommendations. RMD Open. 2018;4(1):e000612.
Chrysidis S, Duftner C, Dejaco C, Schafer VS, Ramiro S, Carrara G, et al. Definitions and reliability assessment of elementary ultrasound lesions in giant cell arteritis: a study from the OMERACT Large Vessel Vasculitis Ultrasound Working Group. RMD Open. 2018;4(1):e000598.
Schafer VS, Juche A, Ramiro S, Krause A, Schmidt WA. Ultrasound cut-off values for intima-media thickness of temporal, facial and axillary arteries in giant cell arteritis. Rheumatology (Oxford). 2017;56(9):1632.
Diamantopoulos AP, Haugeberg G, Lindland A, Myklebust G. The fast-track ultrasound clinic for early diagnosis of giant cell arteritis significantly reduces permanent visual impairment: towards a more effective strategy to improve clinical outcome in giant cell arteritis? Rheumatology (Oxford). 2015.
Patil P, Williams M, Maw WW, Achilleos K, Elsideeg S, Dejaco C, et al. Fast track pathway reduces sight loss in giant cell arteritis: results of a longitudinal observational cohort study. Clin Exp Rheumatol. 2015;33(2 Suppl 89):S-103–6.
Diamantopoulos A, Haaversen AB. 085. The anteromedial ultrasound examination of the large supraaortic vessels identifies higher rates of large vessel involvement than previous reported in patients with giant cell arteritis. Rheumatology. 2019;58 Suppl 2:kez058.25.
Haaversen AB HV, Nabizadeh S, Slagsvold A, Diamantopoulos AP. Ultrasound to monitor treatment response in large vessel giant cell arteritis. Arthritis Rheumatol. 2019;71.
Touboul PJ, Hennerici MG, Meairs S, Adams H, Amarenco P, Bornstein N, et al. Mannheim carotid intima-media thickness and plaque consensus (2004–2006–2011). An update on behalf of the advisory board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th European Stroke Conferences, Mannheim, Germany, 2004, Brussels, Belgium, 2006, and Hamburg, Germany, 2011. Cerebrovascular diseases. 2012;34(4):290–6.
Terslev L, Diamantopoulos AP, Dohn UM, Schmidt WA, Torp-Pedersen S. Settings and artefacts relevant for Doppler ultrasound in large vessel vasculitis. Arthritis Res Ther. 2017;19(1):167.
Schafer VS, Chrysidis S, Dejaco C, Duftner C, Iagnocco A, Bruyn GA, et al. Assessing Vasculitis in Giant Cell Arteritis by Ultrasound: Results of OMERACT Patient-based Reliability Exercises. J Rheumatol. 2018;45(9):1289–95.
Aschwanden M, Daikeler T, Kesten F, Baldi T, Benz D, Tyndall A, et al. Temporal artery compression sign–a novel ultrasound finding for the diagnosis of giant cell arteritis. Ultraschall Med. 2013;34(1):47–50.
Fernandez-Fernandez E, Monjo-Henry I, Bonilla G, Plasencia C, Miranda-Carus ME, Balsa A, et al. False positives in the ultrasound diagnosis of giant cell arteritis: some diseases can also show the halo sign. Rheumatology (Oxford). 2020.
Diamantopoulos AP, Haugeberg G, Hetland H, Soldal DM, Bie R, Myklebust G. The diagnostic value of color Doppler ultrasonography of temporal arteries and large vessels in giant cell arteritis: A consecutive case series. Arthritis care & research. 2013.
Chrysidis S, Lewinski M, Schmidt WA. Temporal arteritis with ultrasound halo sign in eosinophilic granulomatosis with polyangiitis. Rheumatology (Oxford). 2019;58(11):2069–71.
Dasgupta B, Smith K, Khan AAS, Coath F, Wakefield RJ. Slope sign’: a feature of large vessel vasculitis? Ann Rheum Dis. 2019;78(12):1738.
Milchert M, Brzosko M, Bull Haaversen A, Diamantopoulos AP. Correspondence to ‘Slope sign’: a feature of large vessel vasculitis? Ann Rheum Dis. 2019.
Gribbons KB, Ponte C, Carette S, Craven A, Cuthbertson D, Hoffman GS, et al. Patterns of Arterial Disease in Takayasu's Arteritis and Giant Cell Arteritis. Arthritis care & research. 2019.
De Miguel E, Beltran LM, Monjo I, Deodati F, Schmidt WA, Garcia-Puig J. Atherosclerosis as a potential pitfall in the diagnosis of giant cell arteritis. Rheumatology (Oxford). 2018;57(2):318–21.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Haaversen, A.C.B., Diamantopoulos, A.P. (2021). Ultrasound in Large Vessel Vasculitis. In: Akram, Q., Basu, S. (eds) Ultrasound in Rheumatology. Springer, Cham. https://doi.org/10.1007/978-3-030-68659-8_8
Download citation
DOI: https://doi.org/10.1007/978-3-030-68659-8_8
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-68658-1
Online ISBN: 978-3-030-68659-8
eBook Packages: MedicineMedicine (R0)