2022 ACR/EULAR classification criteria for Takayasu arteritis. Requires imaging evidence of large-vessel vasculitis and age ≤60 years. Score ≥5 classifies as TAK.
≥5Score threshold
93.8%Sensitivity
99.2%Specificity
2022Published
!
Entry Requirements (both required)
Before applying these criteria:
Imaging evidence of large-vessel vasculitis (aorta or branch arteries) must be present, and the patient must be age 60 or younger at diagnosis. These are classification criteria, not diagnostic criteria.
Both entry requirements must be met before scoring
1
Clinical and Physical Examination
Demographics (+1)
Symptoms (+2 each)
Vascular Exam (+2 each)
Blood Pressure (+1)
2
Imaging Findings
Number of affected arterial territories
Count distinct territories with luminal damage (stenosis, occlusion, or aneurysm) detected by angiography or vascular ultrasound. Territories include: aorta, carotid, subclavian, vertebral, axillary, brachial, renal, iliac, femoral, and other branch arteries.
Classification Score
0
of 19 max points
019
Entry not met
Confirm imaging evidence and age ≤60 before scoring.
Item Breakdown
Female sex+1
Angina+2
Limb claudication+2
Arterial bruit+2
Upper extremity pulse reduced+2
Carotid pulse/tenderness+2
BP difference ≥20 mmHg+1
Affected territories+0
Paired artery involvement+1
Abdominal aorta + renal/mes.+3
Classification criteria only. Not a diagnostic tool. Does not replace clinical judgment or specialist consultation.
Frequently Asked Questions
Imaging evidence of large-vessel vasculitis is an absolute entry requirement. Acceptable modalities include CT angiography, MR angiography, catheter-based (conventional) angiography, ultrasound, and FDG-PET. The imaging must demonstrate vasculitis or luminal changes (stenosis, occlusion, dilation, or aneurysm) in the aorta or its primary branch arteries.
Count distinct arterial territories with luminal damage detected on imaging. Territories include the aorta (thoracic and abdominal), carotid arteries, subclavian arteries, vertebral arteries, axillary arteries, brachial arteries, renal arteries, iliac arteries, femoral arteries, and other named branch vessels. Each territory counts once regardless of the extent of involvement. The score is +1 for 1 territory, +2 for 2 territories, and +3 for 3 or more territories.
The 2022 ACR/EULAR criteria for TAK require age 60 or under, while GCA criteria require age 50 or over. This creates an overlap zone from ages 50 to 60 where a patient could theoretically meet entry requirements for both criteria sets. In this age range, the full clinical picture - including cranial features, disease distribution, and pace of illness - must guide which criteria set is applied. The criteria themselves do not resolve this ambiguity.
This criterion (+3) is met when imaging shows luminal damage involving the abdominal aorta together with involvement of either the renal arteries or mesenteric arteries. This pattern of below-diaphragm aortic disease with visceral vessel involvement is particularly characteristic of TAK compared to GCA, which tends to involve above-diaphragm vessels preferentially.
These criteria were developed and validated in adult patients. Pediatric TAK (onset under 18 years) is a distinct entity with separate criteria from the EULAR/PRINTO/PRES Ankara 2008 consensus. The 2022 ACR/EULAR TAK criteria should be applied with caution in pediatric patients and have not been formally validated in that population.
Source: Grayson PC, et al. 2022 American College of Rheumatology/EULAR Classification Criteria for Takayasu Arteritis. Arthritis Rheumatol. 2022;74(12):1872-1880. doi:10.1002/art.42324 ↗
| Also published in Ann Rheum Dis. 2022;81(12):1654-1660. doi:10.1136/ard-2022-223482 ↗