#2-09E. Expanding GCA Ultrasound: Is Axillary Artery Assessment Essential for Cranial Phenotypes? (RHEUM, 2025)

Giant cell arteritis (GCA) demands prompt and accurate diagnosis to mitigate the risk of severe complications like irreversible vision loss1. Does relying solely on temporal artery (TA) ultrasound (US) provide sufficient diagnostic confidence, or is an extended assessment crucial, even in patients presenting with purely cranial symptoms? This retrospective study analyzed 230 patients with confirmed GCA to determine the diagnostic utility of incorporating axillary (AX), facial (FA), occipital (OC), subclavian (SC), and common carotid (CC) artery US alongside the standard TA evaluation. The research found that while TA US alone identified GCA in 89.6% of cases, the addition of AX US increased the overall diagnostic yield by 9.6%, confirming GCA in 99.1% of the cohort3. This crucial finding demonstrated that AX assessment is valuable even in cases with predominantly cranial symptoms, providing essential evidence to support the recent EULAR guidelines advocating for routine AX evaluation45. Conversely, the study found no substantial benefit in adding FA, OC, SC, or CC arteries to the TA and AX protocol6. Clinicians should be mindful, however, that the study’s retrospective design and the fact that sonographers were not blinded to clinical data introduce a potential for selection and observer bias78. This paper reinforces the need for comprehensive US protocols that include AX evaluation, enabling physicians to make swift, evidence-based treatment decisions.

Citation: Martins-Martinho J et al. The value of axillary, facial, occipital, subclavian and common carotid arteries ultrasound in the diagnosis of giant cell arteritis. Rheumatology. 2025.

DOI: https://doi.org/10.1093/rheumatology/keae321.

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