Temporal artery biopsies (Re: ANZ J. Surg. 2010; 80: 479–80)

I read with interest the article regarding temporal artery biopsy but would ask the authors to clarify how performing a temporal artery biopsy altered the management of those with suspected giant cell arteritis (GCA). The diagnosis of GCA is a clinical diagnosis with a positive biopsy result contributing to this. As stated, the American College of Rheumatology score is a validated scoring system with 93.5% sensitivity and 91.2% specificity. If your positive biopsy specimens already scored 3 or greater on the ACR, then they need not have been carried out in the first place with a diagnosis of GCA already being made. I agree wholeheartedly that clinical acumen in selecting those where temporal artery biopsy will alter a patient’s management is imperative.