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Objective.Large vessel uptake on positron emission tomography/computerized tomography (PET/CT) supports the diagnosis of giant cell arteritis (GCA). Its value, however, in patients without arteritis on temporal artery biopsy and in those receiving glucocorticoids remains unknown. We compared PET/CT results in GCA patients with positive (TAB+) and negative temporal artery biopsies (TAB−), and controls.Methods.Patients with new clinically diagnosed GCA starting treatment with glucocorticoids underwent temporal artery biopsy and PET/CT. Using a visual semiquantitative approach, 18F-fluorodeoxyglucose (FDG) uptake was scored in 8 vascular territories and summed overall to give a total score in patients and matched controls.Results.Twenty-eight patients with GCA and 28 controls were enrolled. Eighteen patients with GCA were TAB+. Mean PET/CT scores after an average of 11.9 days of prednisone were higher in patients with GCA compared to controls, for both total uptake (10.34 ± 2.72 vs 7.73 ± 2.56; p = 0.001), and in 6 of 8 specific vascular territories. PET/CT scores were similar between TAB+ and TAB− patients with GCA. The optimal cutoff for distinguishing GCA cases from controls was a total PET/CT score of ≥ 9, with an area under the receiver-operating characteristic curve of 0.75, sensitivity 71.4%, and specificity 64.3%. Among patients with GCA, these measures correlated with greater total PET/CT scores: systemic symptoms (p = 0.015), lower hemoglobin (p = 0.009), and higher platelet count (p = 0.008).Conclusion.Vascular FDG uptake scores were increased in most patients with GCA despite exposure to prednisone; however, the sensitivity and specificity of PET/CT in this setting were lower than those previously reported.

Colobronchial fistula is an uncommon complication of Crohn's Disease. It is also rarely diagnosed on first presentation. We describe a case of colobronchial fistula and recurrent pneumonia in a patient with Crohn's Disease. A 52-year-old gentleman with a history of Crohn's Disease presented with cavitating left lower lobe pneumonia that did not resolve despite a one month course of antibiotics. A computed tomography of the thorax confirmed the presence of a cavitating left lower lobe pneumonia. A subsequent abdominal computed tomography revealed a fistulous communication between the colon at the splenic flexure and the left bronchial space. The patient underwent surgery and a fibrous tract was visualized from the splenic flexure to the left lung. Medical treatment was continued with a six week course of antibiotics and the patient was doing well 12 weeks after surgery. There have been few case reports of colobronchial fistula with a clinical picture similar to this case.