KrazyK
Forum Newbie
Topics: 4
Posts: 14
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There seems to be a discrepancy between the Kaplan books and Board Simulator Series regarding dx of temporal arteritis.
Kaplan says temporal artery biopsy is diagnostic confirmatory test of choice for temporal arteritis.
Ona Board Simulator ? that asks how to confirm a diagnosis of temporal arteritis the answer is elevated ESR. It says temp artery biopsy is negative in 40% of cases of temp arteritis so it is not a good confirmatory test.
If someone could clarify exactly what the role of each test is, I would greatly appreciate it.
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| rm
Forum Senior
Topics: 16
Posts: 77
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According to Harrion's:
Diagnosis
The diagnosis of giant cell arteritis and its associated clinicopathologic syndrome can often be suggested clinically by the demonstration of the complex of fever, anemia, and high ESR with or without symptoms of polymyalgia rheumatica in a patient >50 years. The diagnosis is confirmed by biopsy of the temporal artery. Since involvement of the vessel may be segmental, positive yield is increased by obtaining a biopsy segment of 3 to 5 cm together with serial sectioning of biopsy specimens. Ultrasonography of the temporal artery has been reported to be helpful in diagnosis. A temporal artery biopsy should be obtained as quickly as possible in the setting of ocular signs and symptoms, and under these circumstances therapy should not be delayed pending a biopsy. In this regard, it has been reported that temporal artery biopsies may show vasculitis even after more than 14 days of glucocorticoid therapy. A dramatic clinical response to a trial of glucocorticoid therapy can further support the diagnosis.
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| sturge_weber
Forum Guru
Topics: 77
Posts: 1,042
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in temporal arteritis, when the patient comes with the typical symptoms and u suspect, then esr is the screening test of choice...
but the confirmatory test of choice is biopsy
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| chemamr
forum moderator
Topics: 703
Posts: 4,462
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the main question is about the CONFIRMATORY test, the answer to that is temp art biopsy, doubtless.
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