Biopsy for Giant Cell Arteritis — One Side or Both Sides?

Is unilateral or bilateral temporal artery biopsy preferable in patients with suspected giant cell arteritis (GCA)? In this report, researchers describe findings in 310 patients who underwent simultaneous bilateral biopsies at one academic medical center. At the time of biopsy, most patients already were receiving steroid therapy (average duration, 2 weeks). Mean length of biopsy specimens was adequate (1.65 cm).

Biopsy was positive in 91 patients (29%) — on both sides in 80, and on only one side in 11. Most of the latter 11 patients had bilateral symptoms that could not have directed a surgeon to one preferable side. About one third of patients had prebiopsy temporal artery duplex ultrasound (usually within 1 day after starting steroids), b…