Gabriela Stanislavova
Introduction
Giant cell arteritis (GCA) is a vasculitis affecting medium- and large-sized arteries and can lead to complications like vision loss. Temporal artery biopsy (TAB) remains the diagnostic gold standard but has recognised limitations, including reduced sensitivity due to skip lesions and prior corticosteroid use. Increasing interest in non-invasive imaging and clinical classification criteria challenges the ongoing role of TAB in clinical practice. This audit assessed whether TAB results influence long-term management of GCA and evaluated the role of non-invasive imaging and classification criteria.
Methods
A retrospective clinical audit was conducted of patients undergoing TAB for suspected GCA at Southport and Ormskirk Hospitals between January 2020 and November 2025. Demographic data, presenting symptoms, investigation findings, biopsy results, and corticosteroid management were collected from clinical records. Participants were scored using the ACR/EULAR classification criteria for GCA, excluding biopsy results. Descriptive statistics, chi-squared and logistic regression analyses were performed.
Results
Data from 112 participants were analysed. 22% had positive TAB. No significant association was identified between biopsy and ultrasound results. 79% of participants met ACR/EULAR classification criteria for GCA without biopsy results. Logistic regression demonstrated significant associations between CRP level and biopsy outcome (p=0.039), and between ACR/EULAR score and biopsy positivity (p<0.001).
Conclusion
TAB results had limited impact on long-term management, as many patients continued corticosteroid therapy despite negative biopsy. Clinical presentation, inflammatory markers, and classification criteria may play a greater role in guiding management, supporting increased use of non-invasive diagnostic approaches in suspected GCA.
Authors
Gabriela Stanislavova, Southport and Formby District General Hospital, Southport, United Kingdom
Theodore Marples, Whiston Hospital, Prescot, United Kingdom
George Maroufidis, Southport and Formby District General Hospital, Southport, United Kingdom
Frank Mason, Southport and Formby District General Hospital, Southport, United Kingdom