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Letter
‘Slope sign’: a feature of large vessel vasculitis?
  1. Bhaskar Dasgupta1,
  2. Kate Smith1,2,
  3. Abdullah Abu Syeed Khan1,
  4. Fiona Coath1,
  5. Richard J Wakefield3
  1. 1 Rheumatology, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, UK
  2. 2 Rheumatology, Chapel Allerton Hospital, Leeds Biomedical Research Centre, Leeds, UK
  3. 3 Rheumatology, University of Leeds, Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK
  1. Correspondence to Dr Bhaskar Dasgupta, Rheumatology, Southend Hospital NHS Trust, Westcliff-on-Sea SS0 0RY, UK; bhaskar.dasgupta{at}southend.nhs.uk

https://doi.org/10.1136/annrheumdis-2019-216213

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    Ultrasound (US) scanning in the diagnosis of large vessel giant cell arteritis (LV-GCA) is becoming more prevalent, with the advantage of being non-invasive and free of ionising radiation.1 The recent European League against Rheumatism (EULAR) recommendations suggest that US should be the first-line investigation for cases of suspected GCA where adequate equipment and expertise is available.2 3 US is also having a more prominent role in disease monitoring. Biologics such as Tocilizumab have now been approved to treat relapsing and refractory LV-GCA; however, it has been noted that while Tocilizumab may suppress serum inflammatory markers (ie, C reactive protein and erythrocyte sedimentation rate (ESR)) it may underestimate on-going vessel wall disease activity.4 Consequently, the use of US …

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    Footnotes

    • Handling editor Josef S Smolen

    • Contributors BD performed the scans; BD, AASK and KS selected the scans, BD, AASK, KS, FC and RJW contributed to data analysis and writing the manuscript.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.