The American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) reported updated criteria for Giant Cell Arteritis (GCA) in 2022.
Requirements:
(1) age >= 50 years at the time of diagnosis
(2) alternative diagnoses excluded
(3) diagnosis has been made of medium or large vessel vasculitis
Parameters:
(1) morning stiffness of shoulders and/or neck
(2) sudden visual loss
(3) jaw or tongue claudication
(4) new temporal headache
(5) scalp tenderness
(6) abnormal examination of the temporal artery (hard and cord-like; tenderness; absent or diminished pulse)
(7) maximum inflammatory markers (ESR or CRP)
(8) positive temporal artery biopsy or halo sign on temporal artery ultrasound
(9) bilateral axillary artery involvement (stenosis, occlusion, aneurysm, halo sign and/or FDG-PET uptake)
(10) FDG-PET activity throughout aorta (greater than liver uptake in descending and abdominal aorta)
|
Parameter
|
Finding
|
Points
|
|
morning stiffness
|
no
|
0
|
|
|
yes
|
2
|
|
sudden visual loss
|
no
|
0
|
|
|
yes
|
3
|
|
claudication
|
no
|
0
|
|
|
yes
|
2
|
|
new temporal headache
|
no
|
0
|
|
|
yes
|
2
|
|
scalp tenderness
|
no
|
0
|
|
|
yes
|
2
|
|
abnormal exam
|
no
|
0
|
|
|
yes
|
2
|
|
inflammatory markers
|
ESR >= 50 mm/H
|
3
|
|
|
CRP >= 10 mL/L
|
3
|
|
|
neither
|
0
|
|
abnormal temporal artery
|
no
|
0
|
|
|
yes
|
5
|
|
bilateral axillary artery
|
no
|
0
|
|
|
yes
|
2
|
|
aorta FDG-PET uptake
|
no
|
0
|
|
|
yes
|
2
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 25
• A score >= 6 indicates giant cell arteritis.
Performance:
• The area under the ROC curve is 0.91.
