Considerations when applying these criteria | |
| |
Absolute requirement | |
Age ≥50 years at time of diagnosis | |
Additional clinical criteria | |
Morning stiffness in shoulders/neck | +2 |
Sudden visual loss | +3 |
Jaw or tongue claudication | +2 |
New temporal headache | +2 |
Scalp tenderness | +2 |
Abnormal examination of the temporal artery* | +2 |
Laboratory, imaging, and biopsy criteria | |
Maximum ESR ≥50 mm/hour or maximum CRP ≥10 mg/liter¶ | +3 |
Positive temporal artery biopsy or halo sign on temporal artery ultrasoundΔ | +5 |
Bilateral axillary involvement◊ | +2 |
FDG-PET activity throughout aorta§ | +2 |
ESR: erythrocyte sedimentation rate; CRP: C-reactive protein; FDG-PET: fluorodeoxyglucose positron emission tomography; DCVAS: Diagnostic and Classification Criteria in Vasculitis.
* Examination of the temporal artery showing absent or diminished pulse, tenderness, or hard "cord-like" appearance.
¶ Maximum ESR or CRP values prior to initiation of treatment for vasculitis.
Δ Presence of either definitive vasculitis on temporal artery biopsy or halo sign on temporal artery ultrasound. There are no specific histopathologic criteria to define definitive vasculitis on temporal artery biopsy. Presence of giant cells, mononuclear leukocyte infiltration, and fragmentation of the internal elastic lamina were independently associated with histopathologic interpretation of definitive vasculitis in the DCVAS cohort. Halo sign is defined by the presence of a homogenous, hypoechoic wall thickening on ultrasound.
◊ Bilateral axillary involvement is defined as luminal damage (stenosis, occlusion, or aneurysm) on angiography (computed tomography, magnetic resonance, or catheter-based) or ultrasound, halo sign on ultrasound, or FDG uptake on PET.
§ Abnormal FDG uptake in the arterial wall (eg, greater than liver uptake by visual inspection) through the descending thoracic and abdominal aorta on PET.Do you want to add Medilib to your home screen?