What are the ACR classification criteria for giant cell arteritis (GCA) (temporal arteritis)?

Updated: Sep 03, 2020
  • Author: Mythili Seetharaman, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

The following are classification criteria for GCA issued by the American College of Rheumatology in 1990 [55] :

  • Age 50 years or older
  • New-onset localized headache or localized head pain
  • Temporal artery tenderness to palpation or decreased pulsation
  • ESR of 50 mm/h or higher
  • Positive arterial biopsy results (vasculitis characterized by mononuclear infiltration or granulomatous inflammation, usually with multinucleated giant cells)

The presence of 3 or more criteria yields a diagnostic sensitivity of 93.5% and specificity of 91.2%. However, in one study, the American College of Rheumatology classication criteria misclassifed up to 25% of ophthalmology patients with GCA. [110]


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