Clinical usefulness of temporal artery biopsy.

Advances in the Diagnosis of Large Vessel Vasculitis

“…[15][16][17][18] TAB may be mistakenly negative when it is not performed or examined in optimal conditions and its sensitivity may be enhanced by improving those conditions. Because lesions may not be homogeneously distributed along the temporal artery, a lengthy fragment must be excised to achieve the maximal diagnostic performance.…”

“…The absence of manifest or subtle cranial symptoms or abnormalities at the careful temporal artery examination is associated with low probability of a positive TAB even in patients who really have GCA. [15][16][17][18] In these cases other diagnostic approaches may achieve higher yield. However, a negative biopsy may be clinically helpful in driving attention toward other potential diagnoses.…”

“…As a result, in a substantial proportion of patients TAB could be avoided. [15][16][17][18] Several investigators have analyzed clinical data associated with TAB results. The absence of manifest or subtle cranial symptoms or abnormalities at the careful temporal artery examination is associated with low probability of a positive TAB even in patients who really have GCA.…”

Diagnosis and Treatment of Giant Cell Arteritis (Temporal Arteritis) – Past, Current and Future Aspects

“…Fiftynine negative biopsies would have been prevented, but six positive biopsies would have been missed (236). The findings jaw claudication, weight loss, pathological temporal artery enlargement, recent head-ache, and scalp tenderness have all been found to predict a positive biopsy (226,233,236,237). It is tentative to suggest that patients exhibiting none of these clinical features combined with a negative ultrasound should not be subjected to TAB before all other causes of current inflammatory manifestations are ruled out.…”

“…Of major concern is the low number of positive biopsies analyzed by pathological departments. Studies during the years 1976 to 2007 have reported findings of GCA in 13 -43.7 % of TABs (19,226,233,234,235). Consequently, predictive markers for a positive biopsy have long been searched for.…”