A New Era for the Early and Non-Invasive Diagnosis of Giant Cell Arteritis: The Use of Fast-Track Ultrasound in Clinical Practice
Abstract
:Featured Application
Abstract
1. Introduction
2. Materials and Methods
Statistical Analysis
3. Results
3.1. Clinical Presentation of Patients Referred to the Fast-Track Clinic
3.2. US Findings in First Referrals
3.3. Relapsing Disease
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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GCA (N= 111) | NOT GCA (N = 176) | Overall (N = 287) | p | |
---|---|---|---|---|
Headache | 74 (66.6%) | 65 (36.9%) | 138 (47.9%) | <0.0001 |
Jaw claudication | 40 (36%) | 4 (2.3%) | 50 (17.3%) | <0.0001 |
Tongue claudication | 11 (9.9%) | 0 | 11 (3.8%) | <0.0001 |
Blurred vision | 6 (5.4%) | 4 (2.3%) | 10 (3.5%) | 0.165 |
Visual loss | 12 (10.8%) | 8 (4.5%) | 20 (6.9%) | 0.041 |
Bilateral visual loss | 3 (2.7%) | 0 | 5 (1.7%) | 0.029 |
Scalp tenderness | 25 (22.5%) | 1 (0.56%) | 26 (9%) | <0.0001 |
Polymyalgia rheumatica | 61 (54.9%) | 66 (37.5%) | 127 (44%) | 0.039 |
Systemic symptoms | 47 (42.3%) | 32 (18.1%) | 79 (27.4%) | <0.0001 |
≥2 systemic symptoms | 10 (9%) | 4 (2.3%) | 14 (4.9%) | 0.011 |
Isolated raised inflammatory markers | 1 (0.9%) | 9 (5.1%) | 10 (3.5%) | 0.058 |
Normal inflammatory markers | 2 (1.8%) | 45 (25.6%) | 47 (16.3%) | <0.0001 |
Fever | 29 (26.1%) | 13 (7.4%) | 42 (24.5%) | <0.0001 |
Weight loss | 33 (29.7%) | 19 (10.7%) | 52 (18%) | <0.0001 |
Arthritis | 5 (4.5%) | 7 (3.9%) | 12 (4.2%) | 0.804 |
Non-productive cough | 3 (2.7%) | 2 (1.1%) | 5 (1.7%) | 0.312 |
Mean ESR value (mm/h) | 59 ± 35 | 58 ± 35 | 58 ± 35 | 0.814 |
Mean CRP value (mg/L) | 43 ± 50 | 42 ± 50 | 42 ± 50 | 0.869 |
Mean prednisone-equivalent dose on the day of US scan (mg/day) | 18 ± 64 | 17 ± 64 | 17 ± 64 | 0.897 |
Not treated with glucocorticoids on the day of US scan | 21 (19%) | 66 (38%) | 87 (30%) | 0.0007 |
Relapse Confirmed (N = 46) | Relapse Not Confirmed (N = 42) | Overall (N = 88) | p | |
---|---|---|---|---|
Headache | 13 (28%) | 19 (45.2%) | 32 (36%) | 0.095 |
Jaw claudication | 1 (2.2%) | 0 | 1 (1.1%) | 0.0336 |
Tongue claudication | 0 | 0 | 0 | na |
Blurred vision | 1 (2.2%) | 2 (4.7%) | 3 (3.4%) | 0.520 |
Visual loss | 0 | 0 | 0 | na |
Bilateral visual loss | 0 | 0 | 0 | na |
Scalp tenderness | 0 | 1 (2.3%) | 1 (1.1%) | 0.304 |
Polymyalgia rheumatica | 15 (32%) | 0 | 15 (17%) | 0.0001 |
Systemic symptoms | 5 (11%) | 4 (9.5%) | 9 (10%) | 0.818 |
≥2 systemic symptoms | 2 (4.3%) | 1 (2.3%) | 3 (3.4%) | 0.604 |
Isolated raised inflammatory markers | 10 (21.7%) | 13 (30.9%) | 23 (25.8%) | 0.329 |
Normal inflammatory markers | 10 (21.7%) | 7 (16.6%) | 17 (19.1%) | 0.547 |
Fever | 2 (4.3%) | 2 (4.7%) | 4 (2.3%) | 0.928 |
Weight loss | 4 (8.6%) | 2 (4.7%) | 6 (6.7%) | 0.418 |
Arthritis/arthralgia | 1 (2.2%) | 3 (7.1%) | 4 (2.3%) | 0.273 |
Non-productive cough | 0 | 1 (2.3%) | 1 (1.1%) | 0.304 |
Mean ESR value (mm/h) | 36 ± 24 | 37 ± 30 | 36 ± 24 | 0.863 |
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Monti, S.; Delvino, P.; Montecucco, C. A New Era for the Early and Non-Invasive Diagnosis of Giant Cell Arteritis: The Use of Fast-Track Ultrasound in Clinical Practice. Appl. Sci. 2022, 12, 1621. https://doi.org/10.3390/app12031621
Monti S, Delvino P, Montecucco C. A New Era for the Early and Non-Invasive Diagnosis of Giant Cell Arteritis: The Use of Fast-Track Ultrasound in Clinical Practice. Applied Sciences. 2022; 12(3):1621. https://doi.org/10.3390/app12031621
Chicago/Turabian StyleMonti, Sara, Paolo Delvino, and Carlomaurizio Montecucco. 2022. "A New Era for the Early and Non-Invasive Diagnosis of Giant Cell Arteritis: The Use of Fast-Track Ultrasound in Clinical Practice" Applied Sciences 12, no. 3: 1621. https://doi.org/10.3390/app12031621
APA StyleMonti, S., Delvino, P., & Montecucco, C. (2022). A New Era for the Early and Non-Invasive Diagnosis of Giant Cell Arteritis: The Use of Fast-Track Ultrasound in Clinical Practice. Applied Sciences, 12(3), 1621. https://doi.org/10.3390/app12031621