We read Dr. de Miguel’s response to our work attentively, and we would like to thank him for his remarks, and comment on certain question to clarify the conclusions of the same.
We share the aim of improving the care of patients with a strong suspicion of giant cell arteritis. In our case, motivated by the large number of temporal artery biopsy requests received by the plastic surgery department in our hospital, and to improve our professional competency, we decided to undertake a prospective comparative study to analyse the sensitivity and specificity of Doppler ultrasound scan vs biopsy.1 For this all of the patients were included for whom a temporal artery biopsy was requested due to the suspicion of vasculitis from February 2015 to July 2016.
The ultrasound scan studies were performed by a professional in the rheumatology department who had been trained in the technique, and we made maximum use of the resources that were available to us when we commenced the study. At the time, the available papers referred to equipment with transducers of at least 8mHz to 10mHz,2,3 so that we used the departmental ultrasound scanner (Mindray® Z6 with a lineal 7L4P transducer). We also adjusted the colour frequency parameters and PRF to achieve the best quality image.
The recently published EULAR recommendations on the use of imaging tests in large vessel vasculitis4 show the parameters and specific equipment which achieve higher sensitivity and specificity. These recommendations and the work of the Ultrasound School of the Spanish Society of Rheumatology will be of great help in standardising the methodology which should be used when researching giant cell arteritis and improving its results.
FinancingThis research received no specific support from public or private sector agencies or not-for-profit bodies.
Please cite this article as: González Porto SA, Silva Díaz MT, Reguera Arias A, Pombo Otero J, González Rodríguez A, Valero Gasalla J, et al. Respuesta. Reumatol Clin. 2019. https://doi.org/10.1016/j.reuma.2019.01.005