SONOWORLD : Subacute Granulomatous Thyroiditis, de Quervain's thyroiditis

Username

Password

153,831 Registered Members as of 05/22/2017.

JavaScript must be enabled in order for you to use Sonoworld.com in standard view. However, it seems JavaScript is either disabled or not supported by your browser. To use standard view, enable JavaScript by changing your browser options, then try again.

Thyroid/parathyroid » General

Subacute Granulomatous Thyroiditis, de Quervain's thyroiditis

« Back to Listing

Author(s) :

Danilo Sirigu, MD

Presentation A 39-year-old man presents with acute onset of pain in the thyroid region, exacerbated by turning the head swallowing. The pain radiates to the jaw.

Caption: Video: Thyroid transverse and longitudinal

Description: The transverse and longitudinal thyroid sonograms show ill-defined hypoechoic areas in the periphery of both the right and left lobe.

Caption: Color Doppler of the Thyroid

Description: Color Doppler ultrasonography shows a marked increase in vascularity predominantly in the hypoechoic areas.

Caption: Color Doppler of the thyroid

Description: Color Doppler ultrasonography shows a marked increase vascularity.

Differential Diagnosis De Quervain thyroiditis
Autoimmune Thyroid Disease and Pregnancy
Hashimoto Thyroiditis
Thyroid Lymphoma
Thyroid Nodule

Final Diagnosis

Subacute Granulomatous Thyroiditis, de Quervain's thyroiditis

Discussion Subacute granulomatous thyroiditis (De Quervain's Thyroiditis ) is a spontaneously remitting inflammatory disease that is probably caused by viral infection. De Quervain's Thyroiditis is the most common cause of a painful thyroid gland.
Ultrasonography demonstrates focal ill-defined hypoechoic areas within the thyroid. Color Doppler demonstrates more or less increased vascularity especially in the periphery of the gland. The increased vascularity is most intense in the hypoechoic areas.
Zacharia et al. reported the utility of color Doppler US in a single case of subacute granulomatous thyroiditis mimicking a thyroid carcinoma. They reported that color Doppler US showed no hypervascularity in the acute stage, and slightly increased vascularity was seen in the recovery stage. In contrast, the case presented here demonstrates a more marked increase in vascularity, particularly in the hypoechoic areas.
Prognosis of subacute thyroiditis is excellent. More than 90% of the patients with de Quervain thyroiditis recover completely, with or without treatment.

Case References

Zacharia TT, Perumpallichira JJ, Sindhwani V, Chavhan G. Gray-scale and color Doppler sonographic findings in a case of subacute granulomatous thyroiditis mimicking thyroid carcinoma. J Clin Ultrasound 2002;30:442-444
Langer JE, Khan A, Nisenbaum HL, Baloch ZW, Horii SC, Coleman BG, et al. Sonographic appearance of focal thyroiditis. AJR Am J Roentgenol 2001; 176:751-754
Sun Young Park, et alt: Ultrasonographic Characteristics of Subacute Granulomatous Thyroiditis. Korean J Radiol 2006;7:229-234

General information sources:
http://en.wikipedia.org/wiki/De_Quervain's_thyroiditis
http://emedicine.medscape.com/article/117446-overview

Technical Details Case provided courtesy of Dr. Danilo Sirigu, founder of the ecomovies web site. To view a wide range of high quality ultrasound video cases please visit Ecomovies at http://www.ecomovies.it/index.asp

Other contents by this AuthorOther Cases in This Category

Thyroid/parathyroid >> General

Parathyroid adenoma
A 55 year old female presents with complaints of gastroesophageal reflux, crampy abdominal pain, depression and osteoporosis. Laboratory results showed a persistently elevated PTH levels.

Diffuse thyroiditis
A 25 year old femae presents with a one week history of a tender midline swelling of the neck. She also had complaints of palpitations and fine tremors of the hand. Laboratory features revealed ...

Papillary carcinoma of the thyroid with cervical nodal metastases
A 25 year old woman presented with firm right lateral neck swelling. She also had a six pound weight loss over a period of one month. An ultrasound of the neck was performed.

Papillary carcinoma of the thyroid
A 57 year old woman with left thyroid lobe enlargement. An ultrasound of the neck was performed.

Submandibular duct calculus
A young woman presented with pain in the right submandibular region. The patient said she could palpate something in her mouth since her pain had started.

Acute parotitis in a child
A 3-year-old girl presented with a very painful swollen right side of her face and neck and fever. This was the first episode. An ultrasound was performed.

Left parathyroid adenomas
A potential kidney donor was detected to have asymptomatic hypercalcemia. An ultrasound of the neck was performed.

Neonatal hyperthyroidism
This is the ultrasound scan of the neck in an infant with a history of maternal hyperthyroidism.

Right parathyroid adenoma
A young man presents with painless swelling on the right side of the neck of 15 days duration. An ultrasound of the neck was performed.

Submandibular gland sialolithiasis
A 9-year-old girl presents with recurrent painful swelling in the region of the left submandibular gland. On examination there was tender swelling with no signs of local inflammation. A focused ...

Parotid abscess with reactive lymphadenitis
This is the scan in a young kid with fever and a painful swelling of the right side of the face. She was treated with a 5-day- course of oral antibiotics; however there was minimal clinical ...

Malignant Melanoma Metastasis to Parotid Gland
A 79-year-old with a history of cutaneous melanoma of the head is referred for ultrasound examination for bilateral swelling of the parotid glands.