ULTRASOUND IN THE DIAGNOSIS OF GIANT CELL ARTERITIS IN A FAST-TRACK CLINIC
By Angie White, Royal Berkshire Hospital
Giant Cell Arteritis (GCA) is the most common form of Large Vessel Vasculitis. It is considered a rheumatological emergency and can lead to blindness or stroke. Immediate high-dose steroids are required for treatment; the treatment, unfortunately, has many side effects.
In the past, Temporal Artery Biopsy (TAB) was considered the gold-standard tool to aid in diagnosis. As the procedure is invasive and expensive, there has been an increasing trend in the UK for a Fast-Track pathway utilising ultrasound over TAB.
The Fast-Track Clinic at the Royal Berkshire Hospital began in May 2021 and has been a great success. 386 GCA ultrasounds were performed in the first three years; only 4 patients went on to have TAB. This not only has improved patient experience by reducing steroid use and by the non-invasive method, but has also decreased time to access the diagnostic tool (average ~6 weeks down to <1 week). This has also saved nearly £1 million in NHS tariffs alone (not including other costs). The author will present the experience and lessons learned over this three-year period to show that ultrasound has been an effective and efficient tool for GCA diagnosis.