Echoes of Change: How Ultrasound Has Transformed Giant Cell Arteritis Detection

Giant cell arteritis (GCA) is the most common form of vasculitis affecting adults. The diagnosis of GCA is suspected in patients older than 50 years of age with a new headache and elevated inflammatory markers. Once the diagnosis of GCA is suspected, patients require urgent treatment with glucocorticoids to prevent ischemic complications such as blindness and stroke. As there are many causes for headache, diagnosing GCA can be a ‘headache’ for many rheumatologists. For years, rheumatologists have relied on the temporal artery biopsy (TAB) as the gold standard for diagnosing GCA, despite the 33–92% sensitivity. As patients with suspected GCA remain on high doses of glucocorticoids, which have multiple side-effects and potential adverse events, rapid access to tests that have a greater impact on clinical decision‑making is essential. Vascular imaging is a non‑invasive tool that can help diagnose, monitor, and predict the course of GCA. This article will focus on how ultrasound has transformed the detection of GCA and its potential to reduce some of the ‘headaches’ faced by both rheumatologists and patients.