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 / Calculator	Prevalence	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.

Blood Test

Finding	Sensitivity	Specificity	Comments, Study
Elevated ESR Duplicate	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	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
Elevated ESR Duplicate	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

Combination of Tests

ACR Criteria

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

History

Headache

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

Untagged

Finding	Sensitivity	Specificity	Comments, Study
Beaded temporal artery	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	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	34%	92%	in patients with suspected TA Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92
Scalp tenderness	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	6%	86%	in patients with suspected TA Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92
Temporal Artery Biopsy	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
Temporal Headache	40%	74%	Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92
Tender temporal artery	26%	90%	in patients with suspected TA Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92
Weight loss	35%	73%	in patients with suspected TA Study: JAMA. 2002;287:92-101. http://jama.ama-assn.org/cgi/content/full/287/1/92