Background The diagnosis of temporal arteritis (TA) usually requires a temporal artery biopsy. Recently it has been reported that a periluminal dark halo, detected by colour duplex ultrasonography (CDU) of the temporal arteries, is a characteristic sign of TA, and commonly appears in these patients.
Objectives To examine the predictive value of the dark halo sign in diagnosing TA.
Methods During a period of 2 years 69 patients suspected of having TA were examined by CDU of both temporal arteries, using the Acuson SEQUOIA 512 with a 7 MHz linear array transducer. Temporal artery biopsy was performed in 32 of the patients. The diagnosis of TA was made if a patient had a positive biopsy, or met all of the 3 following criteria: 1. ACR classification criteria were fulfilled, 2. there was a prompt clinical response to 40–60 mg/day of prednisone, 3. no other diagnosis related to the symptoms was made during a follow-up of 6 months.
Results Periluminal dark halo was observed in 24 of the 69 patients. TA was diagnosed in 12 of them, giving a positive predictive value (PPV) of only 50%. No halo was detected in 45 cases. Only 2 of them had TA, giving a high negative predictive value (NPV) of 96%. The sensitivity and specificity of the halo sign for diagnosing TA were 86% and 78%, respectively.
Conclusion The PPV of the halo sign in CDU of the temporal arteries is unsatisfactory for diagnosing TA. However, The NPV is very high. Thus a negative halo sign can practically serve to rule out a diagnosis of TA and precludes the need for a biopsy in most instances.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.