Ultrasonography-led multimodal diagnostic pathway for giant cell arteritis.

This article evaluates the diagnostic accuracy of a multimodal pathway combining ultrasonography, 18-fluorodeoxyglucose labelled PET-CT, and temporal artery biopsy for giant cell arteritis (GCA). Analyzing 1,000 consecutive referrals at a UK rheumatology center, the study found that ultrasonography of superficial temporal arteries alone had a sensitivity of 62.3%, which improved to 86.1% when extended to axillary and other cranial arteries, and reached 95.7% sensitivity when combined with a second test (biopsy or PET-CT). The pathway also demonstrated a high negative predictive value (98.0%) when clinical filtering and C-reactive protein (CRP) stratification were applied. These findings provide real-world evidence supporting the use of an ultrasonography-led, multimodal diagnostic approach within a specialized multidisciplinary setting to effectively diagnose GCA.