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Do you routinely obtain baseline vascular imaging (CTA, MRA, PET) in patients with suspected GCA, but negative temporal artery biopsy?

Per 2021 GCA Vasculitis Guidelines: low evidence, but conditional recommendation for CTA neck, chest, abd/pelvis. Is anybody following this or do you feel the low evidence outweighs cost/radiation exposure?
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Do you routinely obtain baseline vascular imaging (CTA, MRA, PET) in patients with suspected GCA, but negative temporal artery biopsy?

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2 Answers
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Rheumatology · Mayo Clinic College of Medicine
Answered on

Vascular imaging is particularly helpful in patients with large vessel giant cell arteritis. This patient subset may present with persistent constitutional symptoms, refractory polymyalgia rheumatica, fever of unknown origin, or with vascular signs/symptoms (for example arm claudication). These pati...

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Rheumatology · Mobile Medical Care Inc
Answered on

Ultrasound of the temporal arteries can be performed in conjunction with an assessment of the facial arteries, carotid arteries, subclavian arteries, axillary arteries, and abdominal aorta to improve the diagnostic yield and allow for screening of cranial involvement as well as large artery involvem...

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