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Rheumatology


Answer 2



Figure 2

  1. Temporal artery biopsy. Given this patient’s high probability of having GCA, there is no need for a fundoscopic examination or a 2-dimensional Doppler echocardiogram. Several available modalities may help establish the diagnosis, including temporal artery ultrasound, CT, positron emission tomography, magnetic resonance imaging, and angiographic studies. However, the gold standard for diagnosing GCA remains a temporal artery biopsy demonstrating granulomatous inflammation with intimal hyperplasia and central narrowing (Figure 2).1 A temporal artery biopsy will still show histologic changes after corticosteroids have been administered (7-14 days), but radiologic findings may change.

    REFERENCES
    1. Klein RG, Hunder GC, Stanson AW, Shep SG. Large artery involvement in giant cell (temporal) arteritis. Ann Intern Med 1975;83:806-12.

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