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American College of Rheumatology (ACR) Criteria for the Diagnosis of Temporal (Giant Cell) Arteritis

Purpose: To diagnose temporal (giant cell) arteritis by the presence of certain findings.

Description

Temporal (giant cell) arteritis is a vasculitis which may affect medium and large arteries. It most commonly affects the temporal artery, but may affect any extracranial branch of the carotid arteries as well as other arteries of the head and neck. Occlusion of the arterial lumen results in decreased blood supply with eventual ischemia. It can be diagnosed by the presence of certain criteria.


Symptoms:

(1) headache

(2) fatigue

(3)) anorexia

(4) fever

(5) visual disturbances and diplopia

(6) jaw claudication (ischemic pain while talking or chewing)

 

Criteria

Comment

age at disease onset >= 50 years

occurs only rarely before the age of 50.

new headache

new onset or new type of localized pain in the head

temporal artery abnormality

temporal artery tenderness to palpation, or decreased pulsation, unrelated to arteriosclerosis of cervical arteries

elevated erythrocyte sedimentation rate

ESR >= 50 mm/h by the Westergren method

abnormal temporal artery biopsy

Artery shows vasculitis with predominance of mononuclear cell infiltration or granulomatous inflammation, usually with multinucleated giant cells. The involvement is segmental, so an adequate biopsy is needed for diagnosis.

 

Interpretation:

• The presence of 3 or more criteria indicates that temporal arteritis is present.

 

Performance:

• The sensitivity is 93.5% and specificity 91.2%


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Specialty

Objective

ICD-10