Laskou et al reported a score the diagnosis of giant cell arteritis. The authors are from Southend University, Leeds Teaching Hospitals, and University of Leeds.
Parameters:
(1) age of the patient in years
(2) sex
(3) number of weeks since onset of symptoms
(4) serum CRP in mg/L
(5) headache
(6) polymyalgia
(7) constitutional (fever, night sweats, unintentional weight loss)
(8) ischemia
(9) visual signs (AION, field loss, RAPD, CRAO)
(10) abnormality of temporal artery
(11) abnormality of extra-cranial artery
(12) cranial nerve palsy
(13) alternative cause (infection, cancer, systemic rheumatic disease, disease of head and neck, other)
|
Parameter |
Finding |
Points |
|
age |
<= 49 years |
0 |
|
|
50 to 60 years |
1 |
|
|
61 to 65 years |
2 |
|
|
>= 66 years |
3 |
|
sex |
male |
1 |
|
|
female |
2 |
|
weeks since onset |
> 24 weeks |
0 |
|
|
12 to 24 weeks |
1 |
|
|
6 to 12 weeks |
2 |
|
|
< 6 weeks |
3 |
|
serum CRP |
<= 5 mg/L |
0 |
|
|
6 to 10 mg/L |
1 |
|
|
11 to 25 mg/L |
2 |
|
|
>= 25 mg/L |
3 |
|
headache |
no |
0 |
|
|
yes |
1 |
|
polymyalgia |
no |
0 |
|
|
yes |
2 |
|
constitutional symptoms |
no |
0 |
|
|
single |
1 |
|
|
combination |
3 |
|
ischemic symptoms |
no |
0 |
|
|
yes |
3 |
|
visual signs |
no |
0 |
|
|
yes |
3 |
|
abnormality of temporal artery |
no |
0 |
|
|
tenderness |
1 |
|
|
thickening |
2 |
|
|
pulse loss |
3 |
|
abnormality of extra-cranial artery |
no |
0 |
|
|
thickening |
1 |
|
|
bruit |
2 |
|
|
pulse loss |
3 |
|
cranial nerve palsy |
no |
0 |
|
|
yes |
3 |
|
alternative diagnosis |
no |
0 |
|
|
yes |
-3 |
where:
• The scoring of alternative diagnosis is a little unclear. In Table I the 5 alternative diagnoses are listed separately, suggesting that each is scored -3. However, this does not seem correct, and having more than 2 of these would be unusual. Also the maximum score in the paper is 32, which is the same as here.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -2
• maximum score: 32
• A score >= 10 indicates giant cell arteritis.
Performance:
• The ara under the ROC curve is 0.95.
Specialty: Immunology/Rheumatology
