Comment on: Temporal artery compression sonography for the diagnosis of giant cell arteritis in elderly patients with acute ocular arterial occlusions

DearEditor, I read with interest the article written by Czihal et al., ‘Temporal artery compression sonography for the diagnosis of GCA in elderly patients with acute ocular arterial occlusions’ [1]. However, I have some concerns about the methodology used.

Indeed, Czihal et al. defined a positive diagnosis of GCA by the association of at least three of the five following criteria: age >50 years, typical cranial symptoms, unequivocal symptoms of polymyalgia rheumatica, ESR >30 mm/1 h (reference range 20 mm/1 h) or CRP 1 mg/dl (normal range <0.5 mg/dl) and typical hypoechogenic wall thickening (halo) of the superficial temporal arteries or positive temporal artery biopsy.

These criteria differ from the classic ACR criteria [age >50 years, new-onset headache, temporal artery abnormality (tenderness to palpation or decreased pulsation unrelated to atherosclerosis of cervical arteries), elevated ESR ≥50 mm/h and abnormal temporal artery biopsy].

There is therefore a bias in the method of measuring the sensitivity and specificity of this new method because of the lack of a validated comparator, which prevents any valid conclusion.

Funding: No specific funding was received from any funding agency in the public, commercial or not-for-profit sectors to carry out the work described in this article.

Disclosure statement: None.

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