Arteriosclerosis or Vasculitis? Color Duplex Sonography in Giant Cell Arteritis

To the Editor: We followed with great interest the report by Czihal, et al 1 presenting new possibilities of objective, noninvasive diagnostic procedures that remain insufficient in giant cell arteritis (GCA). We would like to share our clinical experiences with arteritic changes in patients with GCA. Sonographic presentations of vasculitis may be mistaken for arteriosclerosis, especially in elderly patients who typically have GCA. That was the case in a patient with mild systemic manifestations and insidious disease onset. A 64-year-old woman presented with carotidynia — a rare manifestation of GCA. Color duplex sonography (CDS) revealed hypoechoic, homogenous, circumferential but not symmetrical bilateral wall thickening involving carotid and internal carotid arteries up to 15 mm from the carotid … Address correspondence to Dr. Milchert; E-mail: marcmilc{at}hotmail.com