Assessing vasculitis in giant cell arteritis by ultrasound: Results of OMERACT patient-based reliability exercises

Valentin S. Schäfer*, Stavros Chrysidis, Christian Dejaco, Christina Duftner, Annamaria Iagnocco, George A. Bruyn, Greta Carrara, Maria Antonietta D'Agostino, Eugenio De Miguel, Andreas P. Diamantopoulos, Ulrich Fredberg, Wolfgang Hartung, Alojzija Hocevar, Aaron Juche, Tanaz A. Kermani, Matthew J. Koster, Tove Lorenzen, Pierluigi Macchioni, Marcin Milchert, Uffe Møller DøhnChetan Mukhtyar, Cristina Ponte, Sofia Ramiro, Carlo A. Scirè, Lene Terslev, Kenneth J. Warrington, Bhaskar Dasgupta, Wolfgang A. Schmidt

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review


Objective: To test the reliability of Outcome Measures in Rheumatology Clinical Trials (OMERACT) consensus-based ultrasound definitions for normal and vasculitic temporal and axillary arteries in patients with giant cell arteritis (GCA) and in controls. Methods: A preliminary 1-day meeting and a full 3-day meeting fulfilling OMERACT Ultrasound Group guidelines were held. Temporal and axillary arteries were examined at 2 timepoints by 12 sonographers on 4 patients with GCA and 2 controls. The aim was to test inter- and intrareader reliability for normal findings, halo sign, and compression sign. In both meetings, patients had established GCA. Pathology was more recent in the full meeting, which was preceded by 6 h of training. Scanning time was 15-20 min instead of 10-13 min. Results: In the preliminary exercise, interreader reliabilities were fair to moderate for the overall diagnosis of GCA (Light k 0.29-0.51), and poor to fair for identifying vasculitis in the respective anatomical segments (Light k 0.02-0.46). Intrareader reliabilities were moderate (Cohen k 0.32-0.64). In the main exercise, interreader reliability was good to excellent (Light k 0.76-0.86) for the overall diagnosis of GCA, and moderate to good (Light k 0.46-0.71) for identifying vasculitis in the respective anatomical segments. Intrareader reliability was excellent for diagnosis of GCA (Cohen k 0.91) and good (Cohen k 0.71-0.80) for the anatomical segments. Conclusion: OMERACT-derived definitions of halo and compression signs of temporal and axillary arteries are reliable in recent-onset GCA if experienced sonographers (> 300 examinations) have 15-20 min for a standardized examination with prior training and apply > 15 MHz probes.

Original languageEnglish
JournalThe Journal of Rheumatology
Issue number9
Pages (from-to)1289-1295
Publication statusPublished - Aug 2018


  • Diagnosis
  • Giant Cell Arteritis
  • Ultrasound Reliability
  • Vasculitis


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