Color Doppler sonography of the temporal arteries in giant cell arteritis and polymyalgia rheumatica

Lauwerys, Bernard [UCL] Puttemans, Thierry [UCL] Houssiau, Frédéric [UCL] Devogelaer, Jean-Pierre [UCL]

OBJECTIVE: To test the diagnostic value of color Doppler sonography (CDS) of the superficial temporal arteries in patients suffering from giant cell arteritis (GCA). METHODS: The superficial temporal arteries and their frontal and parietal rami were examined by CDS in 11 patients with GCA, 21 patients with polymyalgia rheumatica (PMR), and 32 controls. The peak systolic velocity (Vmax) was measured at the tragus (proximal superficial temporal artery) and at the temporal bone (distal superficial temporal artery) level. Hypoechoic thickening of the vessel wall was systematically searched for. RESULTS: Mean Vmax in the proximal and distal superficial temporal artery was considerably lower in the GCA group [mean (+/- SEM) 30.9 (+/- 5.6) mm/s proximally and 5.8 (+/- 3.7) mm/s distally] compared to the PMR group [mean (+/- SEM) 64.6 (+/- 3.8) mm/s proximally and 49.3 (+/- 4.2) mm/s distally] and the control group [mean (+/- SEM) 56.9 (+/- 2.2) mm/s proximally and 42.6 (+/- 2.2) distally]. Thickening of the vessel wall was found in only 2 patients: one with GCA and one with PMR. Followup of CDS in 6 GCA patients under treatment produced evidence of a significant increase in the mean Vmax at the distal site. CONCLUSION: Decreased blood flow velocity in the superficial temporal artery is very common in GCA patients and rare in PMR patients. Therefore, CDS examination may contribute to the diagnosis of GCA.