Enlighten me about the temporal artery biopsy

[PMRdaughter]

Please enlighten me about how the biopsy is for the temporal artery. I’m a huge baby with medical procedures.

[Marijo1951]

I had the biopsy the day after I was diagnosed with GCA and, in my case, it was definitely positive. I understand that It's less likely to be successful if the patient has been taking pred for any length of time or if the surgeon takes the sample from a place where there happen to be no giant cells. I'll be honest - it wasn't pleasant, but it didn't take that long. It was also reassuring to have a positive result. The surgeon told me that they can anaesthetise the surrounding area, but can't anaesthetise the artery itself as it is likely to collapse. I understand that in some places they are using an ultrasound examination instead of a biopsy, but it isn't yet available everywhere.

[karools16 in reply to Marijo1951]

I was diagnosed GCA 13 years ago. I refused the biopsy. Consultant was fine with my decision and continued caring for me.Any biopsy is awful. Am not that brave.

[Marijo1951 in reply to karools16]

Yes, it wasn't fun. Let's hope the ultrasound exam becomes the norm. Apart from anything else, they can examine a much wider area with ultrasound without it being invasive.

So PMRdaughter, I advise you to find out if ultrasound is available where you live.

[PMRdaughter in reply to Marijo1951]

I will for sure.

[SnazzyD]

Hello,

In short - The local anaesthetic stings for a few seconds like they always do. I didn’t feel anything except at one point my head ached all over. Takes about 20-30 minutes. With hindsight I would have refused because I had been on Pred 60/40mg for 8 days previously with very dramatic good effect. Even though it was negative they still treated me because of my history and symptoms. The only reason to have it to my mind, it that if it is positive if really is and you know it’s all worth it. False negatives are common. The wound is uncomfortable for longer than people expect because it is a minor operation rather than a quick in and out with a needle. They should go through the risks as with any procedure first. As others say, not the best but nowhere near as bad as one’s imagination makes it.

[PMRpro Ambassador]

It's unlikely anyone will be willing to do the biopsy unless you have other symptoms that are suggestive of GCA - and really you aren't describing any so far. So if I were you I'd wait to worry about it until you get to that bridge.

[PMRdaughter in reply to PMRpro]

I’ve had scalp tenderness for 2 years. I also had itching of my scalp since my pregnancy. I thought all of that was related to my skin cancer on my head, but the basal cell carcinoma was only in one spot, not my whole head. I had issues a few months ago with my left eye that were unexplained. I had pain in my left eye. I went to see my eye dr and she looked at the arteries in my eye then and found nothing. Ruled out retinal iritis, which is often related to MS. Then a few months ago I had noticed my “vein” slightly bulging at the side of my head, around my temple. Then I’ve been experiencing pain in my right wrist and what I described to my dr as “bone pain” like a dull ache in my arm and hand.

[PMRdaughter in reply to PMRdaughter]

I hope this is all in my head.

[alvertta]

I had the biopsy two weeks after diagnosis and starting on 60 mg prednisone. It hurt. But just for the minute it took to cut out the samples. I was happy to have the test to confirm 100% the diagnosis from symptoms. Doctor and nurses were kind. The spots they cut were tender for a few weeks.

[Janstr]

When I agreed to having the biopsy I was in a state of shock having been diagnosed with PMR one day & then possible GCA the next. I had researched the net & asked my Rheumatolgist about the point of having the biopsy, as if you have symptoms, they have to treat for GCA anyway regardless of the results. He said it is often useful later on, but I didn't question him further as to what this meant & still font know.

For the procedure, I was in an operating theatre attached to a heart monitor. A little tent thing was taped to my head leaving the artery being operated on uncovered. My hair was shaved off in front of my ear ( it sounds as if a lot is coming off, but it's not much ) & then I was given local anaesetic. A lovely nurse was under the tent with me the whole time holding my hand & talking to me to reassure me & keep my mind off it.

Given that you have to be treated for GCA if you have the clinical symptoms, if given the choice again, I personally would not agree to having this invasive biopsy.

Just one other thing, my hair was due to be cut & highlighted a couple of weeks after the biopsy, but I couldn't bear to let anyone near my wound & therefore hair for several weeks. In the end, my hair was such a mess that I did go.

[PMRpro Ambassador in reply to Janstr]

If you have had a biopsy and it is positive then you will never have the problem of a doctor who didn't see you at the time trying to tell you (or anyone else) that it wasn't really GCA. In addition, one of the criteria for inclusion in clinical trials is that the GCA must have been confirmed by TAB or, nowadays, some other form of imaging.

[Daisychain12]

Did you see my post on your other thread? I had bilateral temporal biopsy. It was NOTHING honestly. I’ve had eyebrow plucks that were worse. I’m not just saying it. Lease don’t be scared sweetheart xxxx

[PMRdaughter in reply to Daisychain12]

Thank you. I’m such a baby. Lol. It’s this sort of stuff I wish I still had my mom around for. I had my bloodwork done today. I’m seeing my family dr in 4 days. Fingers crossed.