The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis

1990/08/01 by Gene G. Hunder, D. Blöch, Daniel A. Bloch +15 · 2,544 citations
Medicine · #Arteritis #Biopsy #Cell Adhesion Molecules Research #Disease #Erythrocyte sedimentation rate #Gastroenterology #Giant cell arteritis #Internal medicine #Medicine #Otitis Media and Relapsing Polychondritis #Pathology #Polymyalgia rheumatica #Rheumatology #Vasculitis #Vasculitis and related conditions

paper · doi:10.1002/art.1780330810

published in Arthritis & Rheumatism 33(8), 1122-1128 (Wiley)

openalex publication_date 1990/08/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/05

Abstract

Criteria for the classification of giant cell (temporal) arteritis were developed by comparing 214 patients who had this disease with 593 patients with other forms of vasculitis. For the traditional format classification, 5 criteria were selected: age greater than or equal to 50 years at disease onset, new onset of localized headache, temporal artery tenderness or decreased temporal artery pulse, elevated erythrocyte sedimentation rate (Westergren) greater than or equal to 50 mm/hour, and biopsy sample including an artery, showing necrotizing arteritis, characterized by a predominance of mononuclear cell infiltrates or a granulomatous process with multinucleated giant cells. The presence of 3 or more of these 5 criteria was associated with a sensitivity of 93.5% and a specificity of 91.2%. A classification tree was also constructed using 6 criteria. These criteria were the same as for the traditional format, except that elevated erythrocyte sedimentation rate was excluded, and 2 other variables were included: scalp tenderness and claudication of the jaw or tongue or on deglutition. The classification tree was associated with a sensitivity of 95.3% and specificity of 90.7%.

Citations

• The American College of Rheumatology 1990 criteria for the classification of vasculitis: Patients and methods

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