Ultrasound vs. biopsy in diagnosing giant cell arteritis in the Royal Victoria Eye and Ear Hospital, Dublin: a clinical comparison.

Giant cell arteritis (GCA) is systemic vasculitis affecting medium and large-sized arteries that can result in vision-threatening complications. Temporal artery biopsy (TAB) has long been considered the gold standard method for diagnosing GCA; however, Doppler ultrasound offers a non-invasive alternative. This study aims to evaluate the accuracy of Doppler ultrasound in comparison to TAB for diagnosing patients with suspected GCA and to determine its impact on treatment decisions. A retrospective study included 56 participants. They all received a Doppler ultrasound and underwent TAB. The accuracy of Doppler ultrasound was compared against TAB outcomes. The impact of ultrasound on determining the timing of steroid treatment and its correlation with biopsy findings was also evaluated. Most participants (87%) reported having headaches,73% had vision problems, 60% showed symptoms of Polymyalgia Rheumatica (PMR). Optic nerve inflammation was observed in 71% of cases. Doppler ultrasound demonstrated a sensitivity rate of 70% and a specificity was 53% compared to TAB. Treatment with steroids was commenced for 90% of patients, with the decision often influenced by Doppler results. The timing of steroid treatment did not affect the TAB outcomes. The biopsy results confirmed GCA in 53% of cases, and around 82% of them were classified as active GCA. While Doppler ultrasound offers a practical alternative, Temporal Artery Biopsy (TAB) is crucial for confirming the diagnosis. Early initiation of steroids guided by clinical and Doppler ultrasound findings is both safe and effective in preventing disease progression and does not impact the biopsy outcome.