A new state-of-the-art specialist ultrasound clinic service at Stepping Hill Hospital is helping to improve the diagnosis of a condition which can cause blindness, and save the sight of many more people.
The hospital’s rheumatology team have set up a new ‘fast track pathway’ using ultrasound techniques to diagnose ‘Giant Cell Arteritis’ (GCA). This is the first consultant-led clinic of its type in Greater Manchester.
GCA is the most common form of vasculitis, usually affecting adults over age 50. It is estimated that every year in the UK, around 3000 people lose some or all of their sight due to GCA. This is usually irreversible.
The condition results in inflammation in the lining of the arteries, most often those in the head and neck, and especially around the temples. Once diagnosed, GCA needs to be treated as quickly as possible with high-dose steroids. If a person hasn’t yet lost their vision, this treatment will usually protect them from sight loss.
GCA has traditionally been diagnosed with a temporal artery biopsy, a form of minor surgery performed in a theatre setting. The waiting times for a biopsy can be up to two weeks, meaning a diagnosis may be delayed.
With the new fast track service, patients can be referred from their GP or a hospital specialist within one working day, and receive it as an outpatient rather than an inpatient. Patients receive a vascular ultrasound scan, performed in the rheumatology department by the specialist vascular imaging team. Results from the tests are relayed back to a consultant rheumatologist who oversees further management and follow up. If the patient has any visual symptoms, a referral to ophthalmology is advised.
The new service and technique set up by the Stockport Rheumatology team is swifter, which ultimately means a timely diagnosis can be made, and more patients’ sight saved. It is also less invasive, safer, and more comfortable for the patient too.
The new ‘fast track pathway’ was pioneered by Professor Bhaskar Dasgupta at Southend University Hospital, and has featured on BBC2’s ‘Trust Me I’m A Doctor’. The technique has been shown to save the sight of a large huge number of patients in the area. The Stockport Rheumatology team are confident the same technique will be just as successful for patients in their catchment area of Stockport, the High Peak and parts of Cheshire.
The team leading the service are Consultant Rheumatologists Dr Louise Mercer and Dr Qasim Akram, alongside support from Accredited Vascular Scientist, Mike Crook at Independent Vascular Services Ltd (pictured above using the scanner) and his team including David Barrett. The new technique uses a probe paid for by the Stockport NHS Charity.
Dr Louise Mercer said:
The fast track pathway ensures that patients with suspected GCA have rapid access to ultrasound scanning and a diagnosis, usually avoiding the need to come in to hospital for a surgical biopsy. It means that accurate steroid treatment can be started in a timely fashion. Additionally, unnecessary steroid treatment for patients who don’t have GCA can be avoided.
“We are also grateful to the Stockport NHS Charity who provided funding so that we were able to purchase the specialist ultrasound probe needed for the new service. We’re really delighted to be able to provide this new service which will help more patients avoid the devastating impacts of blindness.”