van der Geest et al identified clinical findings that are helpful to rule in and to rule out giant cell arteritis (GCA). The authors are from the University of Gronningen, Leeds Teaching Hospitals and the University of Leeds.
Clinical findings associated with a diagnosis of giant cell arteritis:
(1) limb claudication (likelihood ratio 6.0)
(2) jaw claudication (LR 4.9)
(3) temporal artery thickening (LR 4.7)
(4) loss of pulse in the temporal artery (LR 3.3)
(5) platelet count > 400,000 per microliter (LR 3.8)
(6) temporal tenderness (LR 3.1)
(7) ESR > 100 mm/h (LR 3.1)
Clinical findings associated with another diagnosis:
(1) ESR <= 40 mm/h (negative LR 0.2)
(2) serum CRP < 2.5 mg/dL (negative LR 0.4)
(3) age <= 70 years (negative LR 0.5)
No single finding is sufficient to confirm or to exclude the diagnosis. A combination of findings should be used to determine further patient evaluation.
