Volume 50, Issue 2 Summer 2026 JVU 502-107 | Sonographic Examination in the Evaluation of Temporal Arteritis: A Key Diagnostic Component May Help Patients Avoid Surgery-Sonographic Examination in the Evaluation of Temporal Arteritis: A Key Diagnostic Component May Help Patients Avoid Surgery

Sonographic Examination in the Evaluation of Temporal Arteritis: A Key Diagnostic Component May Help Patients Avoid Surgery

Back to course

Pdf Summary

This case series argues that temporal artery duplex ultrasound (TAUS) should be a key first-line tool in evaluating suspected giant cell arteritis (GCA), also called temporal arteritis. Because GCA can rapidly cause irreversible vision loss, diagnosis and treatment must be prompt, but surgical temporal artery biopsy is invasive and can be burdensome. TAUS offers a noninvasive alternative that can show the characteristic “halo sign,” a hypoechoic thickening around the artery wall indicating inflammation.<br /><br />The authors describe two elderly women with headache and elevated inflammatory markers. In the first case, an 83-year-old woman had headache, jaw claudication, temporal tenderness, elevated ESR/CRP, and TAUS showing periarterial inflammation and halo signs in the temporal and frontal arteries. Although corticosteroids were started, she later underwent bilateral temporal artery biopsy, which confirmed GCA. Her symptoms improved with steroids and later tocilizumab, and inflammatory markers normalized. In the second case, a 90-year-old woman had persistent temporal headache and markedly elevated ESR/CRP. TAUS showed halo signs in the frontal, parietal, and temporal branches, strongly supporting GCA. She improved rapidly after high-dose corticosteroids, and follow-up ultrasound showed resolution of the halo signs.<br /><br />The article emphasizes that TAUS can speed diagnosis, guide who truly needs biopsy, and help avoid unnecessary surgery in some patients. It also highlights practical advantages of fast-track ultrasound pathways and close communication between vascular, rheumatology, and surgical teams. The authors conclude that TAUS is a valuable, effective, and noninvasive diagnostic component for suspected GCA.

Keywords

temporal artery duplex ultrasound

giant cell arteritis

temporal arteritis

halo sign

noninvasive diagnosis

temporal artery biopsy

corticosteroids

ESR CRP

vision loss

fast-track ultrasound