Giant cell arteritis is a vasculitis, i.e. inflammation of the artery walls, which generally affects people over the age of 50. Diagnosis can be long and difficult, as the clinical signs are not specific (headache, pain in the jaw, scalp, shoulders and/or pelvis, abdominal pain, weight loss, etc.), but it must be made quickly, given the risk of complications.
The reference method for diagnosis was initially based on clinical suspicion and analysis of a "piece of temporal artery" (biopsy) performed in the operating theatre under local anaesthetic. Since the mid-1990s, improvements in ultrasound techniques have made it possible to identify a sign, known as a halo, on the temporal arteries that is typical of patients with Giant Cell Arteritis. A prospective multicenter study published in 2024 demonstrated that, in patients with a clinical suspicion of Giant Cell Arteritis, if a halo was found on both temporal arteries by ultrasound, there was no need for a biopsy. This study is at the origin of a change in practices in the diagnosis and care of patients suffering from this disabling disease.
To facilitate early diagnosis, a fast-track pathway has been set up. The aim is to make a rapid diagnosis, thereby reducing the risk of after-effects, shortening the length of hospital stays, considering outpatient treatment and limiting the number of biopsies.
The investigators propose to evaluate the performance of this fast-track pathway.
Patient suspected of GCA
Opposition to the use of their data
Patients from North Charente-Martime with suspicion of GCA that are sent to la Rochelle hospital for fast track diagnosis
Cohort
Prospective
Not listed
Performance of the Fast Track Clinic for GCA diagnosis
Number of patients for whom the delay between GCA suspicion and ultrasound result is less than 7 days
Delay in starting corticosteroids
The duration between suspicion of GCA and corticosteroid prescription
Patients with an alternative diagnosis
Number of patients with an alternative diagnosis
Patients ultrasound negative and pathology positive
The number of ultrasound negative patients with a positive result according to pathology analysis of temporal artery biopsy
GCA patients with negative ultrasound and pathology
Number of patients for whom Doppler ultrasound and biopsy analysis results are negative but who are considered to have GCA by the clinician
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