THE TENDER NECK - THYROIDITIS OR THYROID ABSCESS

Following apparent subacute thyroiditis, a 16-year-old girl developed a left thyroid abscess thought to be secondary to steroids and haemato genous spread from a pilonidal abscess. The thyroid suppuration became recurrent and required partial thyroidectomy. Further left-sided absc ess formation in the neck prompted a barium swallow which revealed the source of infection to be a sinus tract arising from the left pirifor m fossa. The patent fourth branchial sinus tract was later excised. Al l patients with a tender thyroid should have ultrasound-guided fine ne edle aspiration to establish the diagnosis. If suppuration is confirme d, a barium swallow is advised to exclude a sinus tract from the pirif orm fossa.