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To the Editor: In his Grand Rounds presentation about temporal arteritis (TA), Dr Hellman¹ described the examination for bruits over the carotid, subclavian, axillary, abdominal aortic, and femoral artery regions. However, he did not describe auscultation of the orbits for bruits in his patient who had presented with, among other symptoms, unilateral blindness. I have long advocated orbital auscultation in cases of suspected TA.^2-3 Indeed, as noted by Hellmann, about a third of patients with TA become blind. Since retinal ischemia is common in TA, it is not surprising that orbital bruits are often heard.

Hellman also discussed the laboratory evaluation findings in TA, including the high sedimentation rate and occasionally elevated alkaline phosphatase, but he did not include the elevations of the ₂- and -globulins, which I have found useful as further confirmatory evidence.

Gordon J. Gilbert, MD
St Petersburg, Fla

1. Hellmann DB. Temporal arteritis: a cough, toothache, and tongue infarction. JAMA. 2002;287:2996-3000. FREE FULL TEXT 2. Gilbert GJ. Eyeball bruits in temporal arteritis. Dis Nerv Syst. 1970;31:130-132. ISI | PUBMED 3. Gilbert GJ. The Significance of Eyeball Bruits in the Diagnosis of Temporal Arteritis. In: Proceedings of the International Headache Symposium; May 16-18, 1971; Elsinore, Denmark:71-74.

To the Editor: In discussing the challenges of . . . [Full Text of this Article]

RELATED ARTICLE

Temporal Arteritis: A Cough, Toothache, and Tongue Infarction
David B. Hellmann
JAMA. 2002;287(22):2996-3000.
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