Related Subjects:
|Thyrotoxicosis and Hyperthyroidism
|Thyroid Storm - Thyrotoxic crisis
|Graves Disease (Thyrotoxicosis)
|Amiodarone and Thyroid disease
|Thyroid Surgery (Thyroidectomy)
|Hypothyroidism
|Hashimoto's thyroiditis
|DeQuervain's thyroiditis
|Subacute Thyroiditis
|Thyroid nodule
|Congenital Hypothyroidism
|Thyroid Function Tests and antibodies
|Post partum thyroiditis
|Sick Euthyroid Syndrome
|Thyroid Exam (OSCE)
|Thyroid Gland anatomy and Physiology
|Thyroid Cancer
📖 About
- 🦠 A benign, self-limiting, and often post-viral inflammatory disorder of the thyroid.
- 🔥 Inflammation causes follicular destruction with release of preformed thyroxine into circulation.
- ⏳ Typically runs a course of several weeks, often resolving spontaneously.
🩺 Clinical Features
- 🤕 Painful, tender thyroid (classically following a viral illness).
- 🌡️ May present with transient thyrotoxicosis due to hormone release.
- ⏳ Symptoms usually burn out after 4–6 weeks, sometimes followed by a short hypothyroid phase before recovery.
- 💪 Pain may radiate to the jaw or ears; systemic malaise and fever are common.
🔬 Investigations
- ⬇️ TSH suppressed (<0.04).
- ⬆️ T3/T4 elevated (reflecting thyrotoxicosis).
- 📈 ESR/CRP raised (helpful clue to inflammatory cause).
- ⬇️ RAI uptake (key distinction from Graves’ disease, which shows high uptake).
🤔 Differential Diagnosis
- ⚠️ Painful thyroid is highly suggestive of subacute thyroiditis.
- Rare alternative: haemorrhage into a cyst within a multinodular goitre.
- Other thyroid causes of thyrotoxicosis (Graves’, toxic multinodular goitre, thyroid adenoma).
🛠️ Management
- 💊 Symptomatic relief with NSAIDs (first line).
- 💉 Corticosteroids may be used if pain or systemic features are severe.
- ❤️ Beta-blockers for control of thyrotoxic symptoms (tachycardia, tremor, palpitations).
- 👀 Monitor TFTs – most patients recover fully, but a small proportion may develop permanent hypothyroidism.
