DIFFERENTIAL-DIAGNOSIS OF A TENDER GOITER

Subacute thyroiditis is generally felt to have a viral etiology, and t he diagnosis is usually obvious when the patient presents with a diffu sely enlarged and very tender thyroid gland associated with elevated f ree T4 levels, elevated sedimentation rate, low radioiodine uptake and /or nonvisualization on scan and often some systemic symptoms. Subacut e thyroiditis can be unilateral or focal (1,2). Corticosteroids are ve ry effective in relieving symptoms of subacute thyroiditis, often with in 24 hr (3). Three patients are presented where the initial impressio n was subacute thyroiditis, there was a clinical response to prednison e, but none of the patients actually had subacute thyroiditis.