Diagnostic Accuracy of Symptoms, Physical Signs, and Laboratory Tests for Giant Cell ArteritisA Systematic Review and Meta-analysis
JAMA Intern Med. Published online August 17, 2020. doi:10.1001/jamainternmed.2020.3050
巨細胞性動脈炎(側頭動脈炎);GCAの症状や身体所見の精度についてのメタ解析
GCA疑いを含む14037名を解析
症状;
顎跛行は有用な症状(LR+4.9)だが、LR-は0.68とされ否定には使えない。
四肢の跛行もLR+6.01と高い。
![Diagnostic Accuracy of Demographics and Symptoms](https://cdn.jamanetwork.com/ama/content_public/journal/intemed/0/m_ioi200047t2_1596731789.37316.png?Expires=2147483647&Signature=GdKiYSLtGO~CaWl8v7UpQINjlFoNyosBLuByIoReKFK0u09Z6nEdyEH-vz9F~W5688vfi-StY2mm0SbbRmcvUNk4EyxluBoZmDzjDO9HZlLlV8bQ8yLSzMl2ksNaRiXlzQimpj~H3bwY1baMkutOH0DpcKLRv34NLdqvWBRxS0nYc3OGqn-w9b8brKze9vxyoO03ZVBH-BzJjmpxg2yECOsayQaxppQ~2zkM7fC5bjARAHDPdaCsqbtfGogrDG22oy500DlJzPg7k91809G21dApfYr9mqqVDOX8CsUKl0Ds~N0KClptkE0GjsLf1tSlLgPVqlsg2WhKjE14CcIMoA__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA)
身体所見と検査所見;
側頭動脈の異常や圧痛などの所見はいずれも特異度は高いが感度はそこまで。
一方CRPや赤沈の検査は感度がそこそこなので、否定したいならば検査で。
![Diagnostic Accuracy of Physical and Laboratory Findings](https://cdn.jamanetwork.com/ama/content_public/journal/intemed/0/m_ioi200047t3_1596731789.40442.png?Expires=2147483647&Signature=Zh9cXBVI0vS~vJo-1doW9lOvqaol1EtnXn6SkS9bFgeFfJEAvmLrk1xfBeMQ5TCbIow11ISqZkXVzTWUgLifSgiLJ1fDS9FJaA8aluuqB6FFDMqrnEikwEk6hD5vLTh~2ri46ufmjsRyrqao9kiYQzYiHs3RCnQVnIkpnq-c2BWm-gVXhw7MEZEgBUrk2aqQMw5WEnOdjUKa43AosXCPNgXOeWsQWic-Ue2apApi8~QVYkCEVrsygBj9VLZM0qJ4EBxOMJXRlAmWPGQciYdtApebKSSXf5cJMxKFrlk496iGLpNr6f3a2Yy64qMq2sT8t3nhbUYB6qyslxhsjlBEAQ__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA)