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Age: 46

Sex: Female

Indication: Neck tenderness

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Case #40


Findings

  • Thyroid gland is normal in size with diffusely heterogeneous parenchymal echotexture
  • Ill-defined, hypoechoic nodule in the left thyroid lobe measuring 2.2 x 1.4 x 1.3 cm with decreased internal Doppler flow
  • Additional scattered tiny (< 5 mm) hypoechoic nodules in both lobes
  • Subcentimeter rounded hypoechoic nodules inferior to the left thyroid lobe


Diagnosis

Subacute thyroiditis

Sample Report

Ill-defined nodule in the left thyroid lobe measuring up to 2.2 cm with decreased internal vascularity in addition to multiple additional subcentimeter nodules, which are favored to relate to subacute thyroiditis in this patient presenting with neck tenderness. Recommend followup ultrasound in 4-6 weeks to assess for improvement in findings.

Subcentimeter nodules inferior to the left thyroid lobe, which may represent reactive lymph nodes and can also be reassessed on followup imaging.


Discussion

  • Remember that subacute thyroiditis is typically painful and results in a heterogeneous appearance of the thyroid gland with hypoechoic, hypovascular nodules, which may predominantly affect one lobe


Images

Ill-defined hypoechoic nodule in the left thyroid lobe with decreased internal vascularity (red arrows), which although not entirely specific is typical for subacute thyroiditis.

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