How Is Vasculitis Diagnosed?

The diagnosis of vasculitis is based on a person’s medical history, physical exam, signs and symptoms, and laboratory tests.

Specialists Involved

A person with vasculitis may be referred to various specialists, including:

• A dermatologist (skin specialist)
• A hematologist (blood specialist)
• A pulmonologist (lung specialist)
• A cardiologist (heart specialist)
• A neurologist (nervous system specialist)
• An ophthalmologist (eye specialist)
• A urologist (urinary tract and urogenital system specialist)
• A nephrologist (kidney specialist)
• An infectious disease specialist

Diagnostic Tests and Procedures

A variety of tests are used to diagnose vasculitis. The type of test chosen will depend on the signs and symptoms a person has. Some of the tests used in the diagnosis of vasculitis include:

• Blood tests. These may be done to look for abnormal levels of blood cells or antibodies, which could be a sign of inflammation in the body.
• Biopsy. During this test, the doctor takes a small sample of tissue from a blood vessel or one of the affected organs and looks at it under a microscope for inflammation or damage. A biopsy is often the best way to make a firm diagnosis of vasculitis.
• Urine analysis. This test might be done to look for abnormal levels of protein or blood cells in the urine, which could be a sign of vasculitis affecting the kidneys.
• EKG (electrocardiogram). This test measures the rate and regularity of the heartbeat, and is done to see if vasculitis is affecting the heart.
• Echocardiogram. This test uses sound waves to create a moving picture of your heart. Echocardiogram provides information about the size and shape of your heart and how well your heart chambers and valves are functioning. The test also can identify areas of poor blood flow to the heart, areas of heart muscle that are not contracting normally, and previous injury to the heart muscle caused by poor blood flow.
• Chest x ray. A chest x ray takes a picture of the organs and structures inside the chest, including the heart, lungs, and blood vessels. A chest x ray may show abnormal changes if vasculitis is affecting the lungs.
• Pulmonary function testing. These are breathing tests that evaluate how well the lungs are working. These tests are done to see if vasculitis is affecting how the lungs work.
• Abdominal ultrasound. This test uses sound waves to create a picture to look for vasculitis affecting the abdominal organs. It is similar to an echocardiogram.
• Computerized tomography (CT) scan. A CT scan provides a computer generated x-ray image of the internal organs. CT scans can be used to look for vasculitis affecting the abdominal organs or the brain.
• Magnetic resonance imaging (MRI). This test uses powerful magnets and radio waves to make images and can be used to look for a vasculitis affecting the brain.
• Angiography. This test may be done to see the flow of blood through the blood vessels and to determine whether they are blocked. During this test, a dye is injected into the blood vessels, and x-ray pictures of the blood vessels are taken.