15/11/2020

Chewing gum to help diagnose giant cell arteritis

This week we published work assessing the “chewing gum test” to help diagnose giant cell arteritis (CGT). This test involves a patient chewing gum for 5 minutes as part of the clinical assessment for GCA. Jaw claudication, whereby patients describe pain in the jaw on prolonged chewing, is a typical symptom…

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05/09/2020

The value of a careful history and examination to help diagnose GCA

A new systematic review published in JAMA Internal Medicine assesses which clinical features are more strongly associated with a diagnosis of giant cell arteritis. I like this article as it reaffirms the value of a careful patient history and examination. Jaw claudication (pain on chewing), an abnormal temporal artery examination, and…

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08/06/2020

MAINRITSAN 3 – Rituximab maintenance therapy for ANCA vasculitis

The optimal duration of Rituximab maintenance therapy for ANCA vasculitis is not known. The French vasculitis group has just published an important article to help answer this question. In this MAINRITSAN-3 study (link), they randomised patients who had previously had 2 years of maintenance Rituximab and were in remission (disease was…

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18/05/2020

Thrombosis or vasculitis – a common conundrum

This image shows a positive “Allen’s” test. It is from a case report that we published in Vascular Medicine journal last weekend. The left hand is pale due to a blood clot occluding the ulnar artery. When blood clots (thromboses) occur in in unusual locations, a hunt must be undertaken to…

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14/04/2020

Look beyond the temporal arteries when using ultrasound to diagnose giant cell arteritis (GCA)

Ultrasound is very popular in Europe to diagnose GCA. Many centres have a specialised GCA ultrasound service and use it in preference to temporal artery biopsy. This practice was supported in the 2018 European (EULAR) guidelines for diagnosing GCA. The temporal arteries on the scalp are the most convenient and highest…

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14/04/2020

Is there a role for routine positron emission tomography (PET) scans in stable patients with giant cell arteritis?

There is uncertainty as to whether GCA patients should undergo routine vascular screening at 6 months (by PET scan or ultrasound) to ensure the disease is well controlled. This paper from our team at Royal North Shore Hospital was published in April 2020. The findings are from a group of 21…

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