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Temporal Artery Biopsy Following Duplex Ultrasonography Indications

Purpose: To determine if a temporal artery biopsy should be performed on a patient with possible temporal arterities based on the study of Alberts and Mosen.

Description

Alberts and Mosen listed indications for when to perform a temporal artery biopsy following duplex ultrasonography. The need for temporal artery biopsy is much less if high quality ultrasonography is available. The authors are from Kaiser Permanente Northwest in Vancouver, Washington.


 

Patient selection: clinical suspicion of temporal arteritis and availability of high quality ultrasonography

 

Parameters:

(1) impact of additional testing on the clinical treatment decision

(2) patient’s risk of temporal arteritis

(3) findings on ultrasonography (with the classic finding the hypoechoic “halo” sign)

 

If the physician is not going to change treatment based on the results of a temporal artery biopsy, then it should not be performed.

 

A temporal artery biopsy can be helpful if there is a discrepancy between the level of risk for temporal arteritis and the findings seen on ultrasonography.

Ultrasonography

Risk of Temporal Arteritis

Temporal Artery Biopsy

positive bilateral

high

No

positive bilateral

intermediate

possibly

positive bilateral

low

Yes

positive unilateral

high

possibly

positive unilateral

intermediate

Yes

positive unilateral

low

Yes

negative

high

Yes

negative

intermediate

possibly

negative

low

No, but monitor

 


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Specialty

Objective

ICD-10