Abstract Background/Aims Giant cell arteritis (GCA) is a type of systemic vasculitis that predominantly affects older adults. Early detection and management is imperative to avoid the drastic complications that can manifest, such as irreversible vision loss. The diagnosis of GCA can be aided by clinical signs, inflammatory markers, temporal artery biopsy (TAB) and arterial ultrasound. However, variability in the use and interpretation of these investigations presents with challenges in clinical practice. The aims are to determine the diagnostic utility of CRP and ultrasound imaging in identifying cases of suspected GCA and to explore their relationship with clinical assessment. Methods Data was retrospectively collected from an electronic clinical database, incorporating records of patients with suspected GCA. Ultrasound reports were obtained from sonographers and relevant information, including inflammatory markers, ultrasound findings, and final treatment outcomes were extracted and analysed. Results A total of 75 patients with suspected GCA were included in this audit. The age distribution revealed an increased incidence with age, peaking in the 60-69 age group (34.7%). CRP was elevated in 59.4% of patients. Out of the 75 patients, 25 patients (33.3%) had positive ultrasound findings and 50 patients (66.7%) had a negative ultrasound. However, 9 patients (18%) with a negative ultrasound were still treated for GCA based on clinical suspicion. In total, 34 patients (45%) received treatment for GCA, reflecting the importance of integrating clinical judgement alongside diagnostic investigations. Conclusion Whilst multiple diagnostic tools are available to support GCA diagnosis, no single modality is sufficient in isolation. Over-reliance on one investigation may lead to misdiagnosis, as normal results do not exclude GCA. This reiterates that, despite the availability of diagnostic results, clinical acumen ultimately prevails. A holistic approach that integrates clinical reasoning remains central to the diagnosis and is vital to reduce the burden that GCA and its complications pose to patients and healthcare. Disclosure R. Kausar: None. A. Tarar: None. C. Oldham: None. A. Longmead: None.
Kausar et al. (2026) studied this question.