Ultrasound Halo Sign Offers Potential for GCA Monitoring

In patients with giant cell arteritis (GCA), ultrasound can be a useful tool for assessing disease activity and glucocorticoid treatment response, suggests a study published in the Annals of the Rheumatic Diseases.

The finding stems from a prospective analysis that included 49 patients with newly diagnosed GCA. At weeks 1, 3, 6, 12, and 24, patients underwent ultrasound assessments of the temporal artery (TA) and axillary artery (AX), and the number of segments with halo and maximum halo intima-media thickness was recorded. Halo features at GCA presentation and first relapse were compared.

Between all time points and baseline, Halo sensitivity to change showed a significant standardized mean difference for temporal artery halo features. A significant standardized mean difference emerged only after week 6 for axillary artery halo features, however, according to the study.

“The number of TA segments with halo and sum and maximum TA halo intima-media thickness showed a significant correlation with erythrocyte sedimentation rate (0.41, 0.44, and 0.48), C reactive protein (0.34, 0.39, and 0.41), Birmingham Vasculitis Activity Score (0.29, 0.36, and 0.35), and glucocorticoid cumulative dose (-0.34, -0.37, and -0.32); no significant correlation was found for the AX halo features,” researchers wrote.

In 94% of first disease relapses, a halo sign was visible. However, the number of segments with halo and the sum of halo intima-media thickness tended to be lower compared with GCA onset, the study found.

—Jolynn Tumolo

Reference:

Ponte C, Monti S, Scirè CA, et al. Ultrasound halo sign as a potential monitoring tool for patients with giant cell arteritis: a prospective analysis. Ann Rheum Dis. 2021;80(11):1475-1482.