| Association of Vascular Physical Examination Findings and Arteriographic Lesions in Large Vessel Vasculitis. | |
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MedLine Citation:
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PMID: 22174204 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: To assess the utility of the vascular physical examination to detect arteriographic lesions in patients with established large vessel vasculitis (LVV), including Takayasu's arteritis (TAK) and giant cell arteritis (GCA). METHODS: In total, 100 patients (TAK = 68, GCA = 32) underwent standardized physical examination and angiography of the carotid, subclavian, and axillary arteries. Sensitivity and specificity were calculated for the association between findings on physical examination focusing on the vascular system (absent pulse, bruit, and blood pressure difference) and arteriographic lesions defined as stenosis, occlusion, or aneurysm. RESULTS: We found 67% of patients had at least 1 abnormality on physical examination (74% TAK, 53% GCA). Arteriographic lesions were seen in 76% of patients (82% TAK, 63% GCA). Individual physical examination findings had poor sensitivity (range 14%-50%) and good-excellent specificity (range 71%-98%) to detect arteriographic lesions. Even when considering physical examination findings in combination, at least 30% of arteriographic lesions were missed. Specificity improved (range 88%-100%) if individual physical examination findings were compared to a broader region of vessels rather than specific anatomically correlated vessels and if ≥ 1 physical examination findings were combined. CONCLUSION: In patients with established LVV, physical examination alone is worthwhile to detect arterial disease but does not always localize or reveal the full extent of arteriographic lesions. Abnormal vascular system findings on physical examination are highly associated with the presence of arterial lesions, but normal findings on physical examination do not exclude the possibility of arterial disease. Serial angiographic assessment is advisable to monitor arterial disease in patients with established LVV. |
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Authors:
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Peter C Grayson; Gunnar Tomasson; David Cuthbertson; Simon Carette; Gary S Hoffman; Nader A Khalidi; Carol A Langford; Carol A McAlear; Paul A Monach; Philip Seo; Kenneth J Warrington; Steven R Ytterberg; Peter A Merkel |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-15 |
Journal Detail:
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Title: The Journal of rheumatology Volume: - ISSN: 0315-162X ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7501984 Medline TA: J Rheumatol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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From the Vasculitis Center, Section of Rheumatology, and the Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts; Department of Biostatistics, University of South Florida, Tampa, Florida; Division of Rheumatology, Mount Sinai Hospital, Toronto, Ontario, Canada; Center for Vasculitis Care and Research, Cleveland Clinic, Cleveland, Ohio; Division of Rheumatology, St. Joseph's Healthcare, McMaster University, Hamilton, Ontario, Canada; Division of Rheumatology, Johns Hopkins University, Baltimore, Maryland; and the Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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