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Imaging in Giant Cell Arteritis

  • Imaging (P Conaghan, Section Editor)
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Abstract

Much progress has been made in the use of imaging as a diagnostic tool in giant cell arteritis (GCA), which assists in the management of patients where the initial diagnosis is unclear. This includes patients with atypical cranial symptoms, or with predominantly systemic, constitutional or limb symptoms. Ultrasound and magnetic resonance imaging are capable of visualising both the cranial and extracranial large vessel circulation, with vessel wall thickening and stenotic lesions being visualised. Computed tomographic angiography is helpful in visualising the aorta for aneurysm complicating GCA but can also detect vessel wall thickening in established large vessel vasculitis. PET-CT is a very sensitive test for early vascular inflammation in extracranial large vessel vasculitis, before aneurysmal or stenotic lesions have developed, of use in the patient with unexplained constitutional symptoms. The place of imaging in the follow-up of GCA is being investigated, and repeated imaging may be useful in select cases. Generally, vascular abnormalities become less defined once glucocorticoid treatment has been started, and therefore, imaging studies must be conducted early as part of a GCA fast-track assessment.

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Asad Khan and Bhaskar Dasgupta declare no conflicts of interest.

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  1. Department of Rheumatology, Southend University Hospital NHS Foundation Trust, Prittlewell Chase, Westcliff-on-Sea, Essex, SS0 0RY, UK

    Asad Khan & Bhaskar Dasgupta

  2. University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK

    Bhaskar Dasgupta

  3. Anglia Ruskin University, Cambridge Campus, East Road, Cambridge, CB1 1PT, UK

    Bhaskar Dasgupta

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Khan, A., Dasgupta, B. Imaging in Giant Cell Arteritis. Curr Rheumatol Rep 17, 52 (2015). https://doi.org/10.1007/s11926-015-0527-y

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