Role of doppler ultrasonography in thyrotoxicosis differentiation between Graves disease and sub-acute thyroiditis
Journal Title: Journal of the Indian Medical Association - Year 2019, Vol 117, Issue 2
Abstract
Graves’ disease (GD) and sub-acute thyroiditis (SAT) are among the commonest causes of thyrotoxicosis. It is prudent to differentiate them because management in terms of subsequent diagnostic evaluation and management is totally disease specific. But it is often difficult to make this distinction without measurement of radioactive iodine uptake (RAIU) which considered as a reference standard. But this facility is not available in most of the smaller cities and towns of India. Color flow doppler ultrasonography which is much more readily available and cheaper allows direct measurement of thyroid function through real-time detection of tissue vascularization and blood flow. In this study 57 patients of thyrotoxicocis after exclusion of toxic nodules were evaluated. Detailed history and physical examination was done with relationship to those pertinent to thyrotoxicosis such as goiter, tachycardia, tremor, eye changes including ophthalmopathy. Thyroid profile was performed. USG including colour Doppler, fine needle aspiration cytology and haemogram were also performed. Tremor, restlessness, palpitation, increased appetite and prominence of eyes were commoner in GD. History of antecedent was present in half of SAT. ESR was much higher in SAT. There was no difference in thyroid profile between them. Increased intrathyroidal blood flow and increased peak systolic velocity (PSV) of inferior thyroid artery (ITA) above 50cm/second has been usually found in hyperthyroidism whereas they are normal or slightly increased in sub-acute thyroisitis.
Authors and Affiliations
L Romesh Sharma, Kritirupa Sarkar, S Subash Singh, Santa Naorem, Lallan Prasad, Salam Ranabir
Keywords
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