Riedel's thyroiditis differential diagnosis: Difference between revisions

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{{Riedel's thyroiditis}}
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==Overview==
==Overview==
*[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
[[Hashimoto's thyroiditis]] must be differentiated from other causes of [[thyroiditis]], such as [[De Quervain's thyroiditis]], [[Riedel's thyroiditis]], and suppurative thyroiditis.
*[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
==Differentiating Hashimoto's Thyroiditis from other Diseases==
*[[Hashimoto's thyroiditis]] must be differentiated from other causes of [[thyroiditis]], such as [[De Quervain's thyroiditis]], [[Riedel's thyroiditis]], and suppurative thyroiditis.<ref name="urlThyroiditis — NEJM">{{cite web |url=http://www.nejm.org/doi/full/10.1056/NEJMra021194 |title=Thyroiditis — NEJM |format= |work= |accessdate=}}</ref>


==Differentiating X from other Diseases==
<br>
*[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
{| align="center"
*[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
 
*As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].
 
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! rowspan="2" |Diseases
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! colspan="4" |History and Symptoms
! rowspan="2" |Other Findings
|-style="background: #4479BA; color: #FFFFFF; text-align: center;"
!Lab Test 1
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!Finding 1
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|style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 1
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|style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 2
|style="background: #F5F5F5; padding: 5px;" |'''↑'''
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|style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 3
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|style="background: #F5F5F5; padding: 5px;" |↓
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|style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 4
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|style="background: #DCDCDC; padding: 5px; text-align: center;" |Differential Diagnosis 5
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{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
! style="background:#4479BA; color: #FFFFFF;" | Conditions
! style="background:#4479BA; color: #FFFFFF;" |Causes
! style="background:#4479BA; color: #FFFFFF;" |Age at onset
! style="background:#4479BA; color: #FFFFFF;" |Pathological findings
! style="background:#4479BA; color: #FFFFFF;" |Diagnostic approach   


===Use if the above table can not be made===
{| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px" align=center
|valign=top|
|+
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Differential Diagnosis}}
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Similar Features}}
! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Differentiating Features}}
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|Differential 1
| align="center" style="background:#DCDCDC;" |[[Hashimoto's thyroiditis]]
| style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
*Autoimmune
| style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
*All ages, peak at 30-50
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Lymphocytic infiltration
*Germinal centers
*Fibrosis (in some variants)
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Thyroid function tests|Increased TSH]] (hypothyroidism)
*[[Thyroid peroxidase|TPO antibodies]] present in high titer
*[[I-123 thyroid imaging|I-123]] uptake usually decreased
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|Differential 2
| style="padding: 5px 5px; background: #F5F5F5;"|
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
| style="padding: 5px 5px; background: #F5F5F5;"|
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|Differential 3
| align="center" style="background:#DCDCDC;" |[[De Quervain's thyroiditis|Painful subacute (De Quervain's) thyroiditis]]
| style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
*Unknown
| style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
*20-60
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Giant cells
*Granulomas
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Thyroid function tests|Increased TSH]] (hypothyroidism) and/or
* [[Thyroid function tests|Decreased TSH]] (Thyrotoxicosis)
*[[Thyroid peroxidase|TPO antibodies]] absent or very low titer
*[[I-123 thyroid imaging|I-123]] uptake decreased
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|Differential 4
| align="center" style="background:#DCDCDC;" |[[Riedel's thyroiditis]]
| style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
*Unknown
| style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
*30-60
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Dense fibrosis
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Thyroid function tests|Normal TSH]] (euthyroidism)
*[[Thyroid peroxidase|TPO antibodies]] usually present
*[[I-123 thyroid imaging|I-123]] uptake decreased or normal
|-
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;"|Differential 5
| align="center" style="background:#DCDCDC;" |[[Suppurative thyroiditis]]
| style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] also observed in [disease name].
*Infection
| style="padding: 5px 5px; background: #F5F5F5;"|
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
* On [physical exam; history; diagnostic test; imaging], [Differential 1] {has; demonstrates} [feature 1], [feature 2], [feature 3] that distinguish it from [disease name].
*Children, 20-40
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*Abscess formation
| style="padding: 5px 5px; background: #F5F5F5;" align="left" |
*[[Thyroid function tests|Normal TSH]] (euthyroidism)
*[[Thyroid peroxidase|TPO antibodies]] absent
*[[I-123 thyroid imaging|I-123]] uptake normal
|}
|}
<br style="clear:left" />


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Revision as of 14:42, 10 August 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2]

Overview

Hashimoto's thyroiditis must be differentiated from other causes of thyroiditis, such as De Quervain's thyroiditis, Riedel's thyroiditis, and suppurative thyroiditis.

Differentiating Hashimoto's Thyroiditis from other Diseases


Conditions Causes Age at onset Pathological findings Diagnostic approach
Hashimoto's thyroiditis
  • Autoimmune
  • All ages, peak at 30-50
  • Lymphocytic infiltration
  • Germinal centers
  • Fibrosis (in some variants)
Painful subacute (De Quervain's) thyroiditis
  • Unknown
  • 20-60
  • Giant cells
  • Granulomas
Riedel's thyroiditis
  • Unknown
  • 30-60
  • Dense fibrosis
Suppurative thyroiditis
  • Infection
  • Children, 20-40
  • Abscess formation


References

  1. ↑ "Thyroiditis — NEJM".

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