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Temporal Arteritis: Sensitivity and Specificity

Introduction: also known as Giant Cell Arteritis.

The estimated 5-year probability of developing visual loss after initiating corticosteroid therapy was 1%; that of additional visual loss in patients who already had visual loss was 13%.

Symptoms not specific to TA: anorexia, arthralgia, fatigue, fever, temporal headache, myalgia or polymyalgia rheumatica, unilateral vision loss or any visual sx, vertigo

Signs not specific to TA: optic atrophy/neuropathy, fundoscopic abnormality, absent temporal artery pulse, anemia.

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Tags: Autoimmune Vasculitis Tag this Diagnosis.

Prevalence

Population / CalculatorPrevalence Comments / Study / Link
Age < 50 0% only 2/1435 patients with temporal arteritis were <50.

JAMA 2002 Jan 2;287(1):92-101. PMID 11754714

Women 0% more common than in men
Patients referred for TA biopsy 39% JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92
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The sensitivity and specificity of findings for Temporal Arteritis are listed below. See the left navigation bar to change the display.

Sensitive and Specific Findings

Finding SensitivitySpecificity Comments, Study
Temporal Artery Biopsy Edit 87.1%100%

for one biopsy. Sensitivity increases with longer artery segment biopsied, or multiple sites.

specificity assumed to be 100%, as this is the gold standard.

Study: Invest Ophthalmol Vis Sci. 2007 Feb;48(2):675-80. PMID: 17251465

ACR Criteria Edit 94%91%

in patients with "a" vasculitis.

>=3/5 criteria:

* Age greater than or equal to 50 years at time of disease onset

* Localized headache of new onset

* Tenderness or decreased pulse of the temporal artery

* Erythrocyte sedimentation rate (ESR) greater than 50 mm/h

* Biopsy revealing a necrotizing arteritis with a predominance of mononuclear cells or a granulomatous process with multinucleated giant cells.

Study: Arthritis Rheum 1990 Aug;33(8):1122-8. PMID 2202311

Specific Findings

Finding SensitivitySpecificity Comments, Study
Beaded temporal artery Edit 9%98%

in patients with suspected TA

Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92

Diplopia Edit 7%98%

in patients with suspected TA

Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92

Jaw claudication Edit 34%92%

in patients with suspected TA

Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92

Tender temporal artery Edit 26%90%

in patients with suspected TA

Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92

Scalp tenderness Edit 17%90%

in patients with suspected TA

Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92

Synovitis Edit 6%86%

in patients with suspected TA

Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92

Sensitive Findings

Finding SensitivitySpecificity Comments, Study
Elevated ESR
Duplicate Edit
98%11%

in patients with suspected TA

Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92

Elevated ESR
Duplicate Edit
92%24%

>50mm/hr. in patients with suspected TA

Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92

Negative Findings

Finding SensitivitySpecificity Comments, Study
Synovitis Edit 6%86%

in patients with suspected TA

Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92

Poorly Diagnostic Findings

Finding SensitivitySpecificity Comments, Study
Elevated ESR
Duplicate Edit
35%82%

>100mm/hr. in patients with suspected TA.

Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92

Temporal Headache Edit 40%74%

Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92

Weight loss Edit 35%73%

in patients with suspected TA

Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92

Headache Edit 72%40%

(not necessarily temporal.) in patients with suspected TA

Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92