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Reply to Koster et al. letter to editor

      Dr. Koster et al, aptly call attention to the distinction in diagnostic and classification criteria and comment criteria proposed by Dejaco and colleagues
      • Dejaco C.
      • Duftner C.
      • Buttgereit F.
      • Matteson E.L.
      • Desgupta B.
      The spectrum of giant cell arteritis and polymyalgia rheumatica: revisiting the concept of the disease.
      were to advise updates for criteria for classification not diagnosis. While true, Dejaco et al.
      • Dejaco C.
      • Ramiro S.
      • Duftner C.
      • et al.
      EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice.
      state “The objective of this project was to provide user-friendly, evidence-based recommendations for the use of imaging modalities for diagnosis, monitoring and outcome of primary LVV”. In their discussion they note, “In summary, we developed 12 recommendations on the use of imaging for the diagnosis and monitoring of LVV”. Our goal was not to “distract from the rigors of decision making,” but to broaden the diagnostic capability afforded by advances in extracranial large vessel imaging underappreciated in the diagnosis in GCA. Our patient was seen by multiple internists, rheumatologists, and stroke neurologists before diagnosed months later with GCA based on large vessel imaging. Understanding and applying the recommended diagnostic imaging
      • Dejaco C.
      • Duftner C.
      • Buttgereit F.
      • Matteson E.L.
      • Desgupta B.
      The spectrum of giant cell arteritis and polymyalgia rheumatica: revisiting the concept of the disease.
      in the appropriate clinical setting proved helpful to our patient.
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      References

        • Dejaco C.
        • Duftner C.
        • Buttgereit F.
        • Matteson E.L.
        • Desgupta B.
        The spectrum of giant cell arteritis and polymyalgia rheumatica: revisiting the concept of the disease.
        Rheumatology. 2017; 56: 506-515
        • Dejaco C.
        • Ramiro S.
        • Duftner C.
        • et al.
        EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice.
        Ann Rheum Dis. 2018; 77: 636-643

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