Giant Cell Arteritis

1990 American College of Rheumatology Classification Criteria for Giant Cell Arteritis

  • Age of onset ≥50 years (symptoms or signs beginning at 50 years or older)
  • New headache (new onset of or new type of localized pain in the head)
  • Temporal artery abnormality£ (tenderness or decreased pulsation)
  • Elevated ESR ≥ 50 mm/hr (by the Westergren method)
  • Abnormal artery biopsy (vasculitis characterized by predominance of mononuclear cell infiltrates or granulomatous inflammation with multinucleated giant cells)

Requirements: ≥ 3 of the above criteria are required for classification as Giant Cell Arteritis.  Sensitivity 93.5%, specificity 91.2%.

Reference: Hunder et al.  The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis.  Arthritis Rheum 1990;33(8):1122-8.

RheumTutor’s note

  • £In clinical practice, temporal artery abnormalities include tenderness, decreased or absent pulsation, induration (cord-like) and nodularity.
  • GCA was previously, and less-appropriately, known as Temporal Arteritis.  Inflammation can involve other intracranial and extracranial arteries.