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Topics:
Rheumatology • Giant cell arteritis • Ultrasound • GCA • Large vessel vasculitis • RheumMadness
How do you make the decision to empirically treat for GCA when a patient is referred but cannot be immediately seen in clinic?
When a PCP calls with concern for GCA and is wondering whether to start empiric steroids what data do you prioritize to make that decision and do you apply a scoring system such as GCAPS?
This question is part of a collaboration with RheumMadness and is specifically in reference to: GCA Fast Track
Answer from: at Academic Institution
This is an important question because referrals for possible GCA are common scenarios when a rheumatologist may be asked to recommend a treatment before seeing the patient which are often challenging scenarior. The factors I typically rely on to rate the probability of GCA include:
- Specific sympt...
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Answer from: at Academic Institution
This case is a prime example of the "art of rheumatology". A real-life scenario where medical decision-making is mostly based on personal and anecdotal experience. Recently developed algorithms such as GCAPS can help identify those patients who are more likely to have GCA, but this is an imperfect t...
Answer from: at Community Practice
I must commend Dr. @Helfgott for his concise and brilliantly crafted response; I wholeheartedly agree with his approach. Ultrasound is such a critical tool in this setting since it allows you to screen the temporal arteries and its branches as well as the facial artery, carotid artery, subclavian ar...
Answer from: at Community Practice
Treatment should not be withheld pending temporal artery biopsy. Although glucocorticoids to reduce the positive rate of biopsies a nice retrospective study of 183 cases out of Sweden showed that 80% of biopsied taken 1-4 weeks after glucocorticoid treatment were still positive Jakobsson et al....