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Clinical Problem Solving: Radiology
May 2012

Radiology Quiz Case 2

Arch Otolaryngol Head Neck Surg. 2012;138(5):519. doi:10.1001/archoto.2012.445a

In June 2011, a 22-year-old woman presented to the emergency department of our hospital with a 3-day history of fevers (temperatures up to 39°C) and painful swelling in the left side of her neck, near the thyroid gland. She was admitted for intravenous antibiotic therapy. She had initially experienced pain and swelling over the left thyroid gland area in March 2011. Physical examination also revealed a 1.5 × 1.5-cm mass with local heat and tenderness. At that time, the patient went to a regional teaching hospital, where subacute thyroiditis was diagnosed. An analgesic was prescribed, and her symptoms subsequently subsided. However, the swelling and tenderness in the left thyroid area recurred after an episode of upper respiratory tract infection in May 2011. The patient visited our outpatient department, where a nonsteroidal anti-inflammatory drug and prednisolone were prescribed. The results of her blood work were normal, and serologic tests were negative for antithyroglobulin antibody and antithyroid peroxidase antibody. Her symptoms again gradually subsided.