KEY FACTS
Terminology
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Autoimmune disorder with long-acting, thyroid-stimulating antibodies producing hyperplasia and hypertrophy of thyroid
Imaging
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Mild/moderate diffuse, symmetric enlargement of thyroid gland, including isthmus
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Hypoechoic, heterogeneous, spotty parenchymal echo pattern
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Marked increase in parenchymal vascularity (turbulent flow with AV shunts): “Thyroid inferno”
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Increased vascularity does not correlate with thyroid function but reflects inflammatory activity
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Spectral Doppler: Increase in peak flow velocity (≤ 120 cm/s) as measured in inferior thyroid artery
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↑ vascularity tends to ↓ in response to treatment
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Diagnosis based on clinical signs and symptoms and laboratory findings, ultrasound is not needed
Top Differential Diagnoses
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Hashimoto thyroiditis
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de Quervain thyroiditis
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Nodular goiter
Clinical Issues
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3rd-4th decade; M:F = 1:7
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Palpitations, loss of weight despite increased appetite, sweating, and wet palms
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Hyperdynamic circulatory state, muscle weakness, fatigue
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Thyroid-associated ophthalmopathy: Periorbital edema, lid retraction, ophthalmoplegia, proptosis, malignant exophthalmos
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Elevated T₃ + T₄ levels and depressed TSH level
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Strong family history of autoimmune disorders
Scanning Tips
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US may be used to establish thyroid volume prior to radioactive iodine treatment
in a patient with Graves disease (GD). Diagnosis of GD is based on clinical features and laboratory tests. Ultrasound is usually not indicated for patient management.
. This appearance overlaps with Hashimoto thyroiditis, but the clinical picture is different.Related posts:
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