Rate of discordant findings in bilateral temporal artery biopsy to diagnose giant cell arteritis

J Rheumatol. 2009 Apr;36(4):794-6. doi: 10.3899/jrheum.080792. Epub 2009 Feb 17.

Abstract

Objective: To determine to what extent performing simultaneous bilateral temporal artery biopsies might increase the diagnostic sensitivity in giant cell arteritis (GCA).

Methods: In total 173 consecutive pathology reports of temporal artery biopsies were reviewed for histological findings by a single pathologist. The rate of discordance of biopsy results was calculated in patients with GCA.

Results: Biopsies were performed bilaterally and simultaneously in 132 cases; 51 had positive results. In 38 the biopsy was positive on both sides (concordant results), while in 13 patients only one side was positive (discordant results), reaching a discordance rate of 13/51=0.255. Therefore 12.7% of the patients (one-half of the discordance rate) could have been misdiagnosed as biopsy-negative had a biopsy been done only unilaterally in those 51 cases.

Conclusion: These data suggest that performing bilateral temporal artery biopsies increases the diagnostic sensitivity of the procedure by up to 12.7%, compared to unilateral biopsies.

MeSH terms

  • Biopsy*
  • Giant Cell Arteritis* / diagnosis
  • Giant Cell Arteritis* / pathology
  • Humans
  • Sensitivity and Specificity
  • Temporal Arteries / pathology*