Differentiating goiter from other diseases: Difference between revisions
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{| style="border: 0px; font-size: 90%; margin: 3px;" align="center" | |||
! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Cause of thyrotoxicosis}} | |||
! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|TSH receptor antibodies}} | |||
! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Thyroid US}} | |||
! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Color flow Doppler}} | |||
! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Radioactive iodine uptake/Scan}} | |||
! colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" | {{fontcolor|#FFFFFF|Other features}} | |||
|- | |||
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Graves' disease}} | |||
| style="padding: 5px 5px; background: #F5F5F5;" | + | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Hypoechoic pattern | |||
| style="padding: 5px 5px; background: #F5F5F5;" | ? | |||
| style="padding: 5px 5px; background: #F5F5F5;" | ? | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Ophthalmopathy, dermopathy, acropachy | |||
|- | |||
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Toxic nodular goiter}} | |||
| style="padding: 5px 5px; background: #F5F5F5;" | - | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Multiple nodules | |||
| style="padding: 5px 5px; background: #F5F5F5;" | - | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Hot nodules at thyroid scan | |||
| style="padding: 5px 5px; background: #F5F5F5;" | - | |||
|- | |||
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Toxic adenoma}} | |||
| style="padding: 5px 5px; background: #F5F5F5;" | - | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Single nodule | |||
| style="padding: 5px 5px; background: #F5F5F5;" | - | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Hot nodule | |||
| style="padding: 5px 5px; background: #F5F5F5;" | - | |||
|- | |||
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Subacute thyroiditis}} | |||
| style="padding: 5px 5px; background: #F5F5F5;" | - | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Heterogeneous hypoechoic areas | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Reduced/absent flow | |||
| style="padding: 5px 5px; background: #F5F5F5;" | ? | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Neck pain, fever, and<br> elevated inflammatory index | |||
|- | |||
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Painless thyroiditis}} | |||
| style="padding: 5px 5px; background: #F5F5F5;" | - | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Hypoechoic pattern | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Reduced/absent flow | |||
| style="padding: 5px 5px; background: #F5F5F5;" | ? | |||
| style="padding: 5px 5px; background: #F5F5F5;" | - | |||
|- | |||
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Amiodarone induced thyroiditis-Type 1}} | |||
| style="padding: 5px 5px; background: #F5F5F5;" | - | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Diffuse or nodular goiter | |||
| style="padding: 5px 5px; background: #F5F5F5;" | ?/Normal/? | |||
| style="padding: 5px 5px; background: #F5F5F5;" | ? but higher than in Type 2 | |||
| style="padding: 5px 5px; background: #F5F5F5;" | High urinary iodine | |||
|- | |||
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Amiodarone induced thyroiditis-Type 2}} | |||
| style="padding: 5px 5px; background: #F5F5F5;" | - | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Normal | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Absent | |||
| style="padding: 5px 5px; background: #F5F5F5;" | ?/absent | |||
| style="padding: 5px 5px; background: #F5F5F5;" | High urinary iodine | |||
|- | |||
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Central hyperthyroidism}} | |||
| style="padding: 5px 5px; background: #F5F5F5;" | - | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Diffuse or nodular goiter | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Normal/? | |||
| style="padding: 5px 5px; background: #F5F5F5;" | ? | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Inappropriately normal or high TSH | |||
|- | |||
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Trophoblastic disease}} | |||
| style="padding: 5px 5px; background: #F5F5F5;" | - | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Diffuse or nodular goiter | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Normal/? | |||
| style="padding: 5px 5px; background: #F5F5F5;" | ? | |||
| style="padding: 5px 5px; background: #F5F5F5;" | - | |||
|- | |||
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Factitious thyrotoxicosis}} | |||
| style="padding: 5px 5px; background: #F5F5F5;" | - | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Variable | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Reduced/absent flow | |||
| style="padding: 5px 5px; background: #F5F5F5;" | ? | |||
| style="padding: 5px 5px; background: #F5F5F5;" | ? Serum thyroglobulin | |||
|- | |||
| colspan="1" rowspan="1" style="background: #4479BA; padding: 5px 5px;" |{{fontcolor|#FFFFFF|Struma ovarii}} | |||
| style="padding: 5px 5px; background: #F5F5F5;" | - | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Variable | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Reduced/absent flow | |||
| style="padding: 5px 5px; background: #F5F5F5;" | ? | |||
| style="padding: 5px 5px; background: #F5F5F5;" | Abdominal RAIU | |||
|} | |||
Revision as of 19:03, 5 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
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].
OR
[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
Differentiating Goiter from other Diseases
- [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].
- [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].
The table below summarizes the findings that differentiate thyroid adenoma from other conditions that cause neck swelling.[1]
Disease | Findings |
---|---|
Multinodular goiter | Multinodular goiter is the multinodular enlargement of the thyroid gland. They are large nodules of more than 1 cm that produces symptoms of hyperthyroidism. |
Grave's disease | Grave's disease is an autoimmune disease that affects the thyroid. It frequently results in hyperthyroidism and an enlarged thyroid. Pretibial myxedema and ophthalmopathy are some of the findings of grave's disease. |
Hashimoto's disease | Hashimoto's disease is an autoimmune disease in which the thyroid gland is attacked by a variety of cell-mediated and antibody-mediated immune processes, causing primary hypothyroidism. |
Medullary thyroid carcinoma | Medullary thyroid carcinoma is a form of thyroid carcinoma which originates from the parafollicular cells (C cells), which produce the hormone calcitonin. |
Thyroid lymphoma | Thyroid lymphoma is a rare malignant tumor which manifests as rapidly enlarging neck mass causing respiratory difficulty. |
De Quervain's thyroiditis | De Quervain's thyroiditis is a subacute granulomatous thyroiditis preceded by an upper respiratory tract infection. |
Acute suppurative thyroiditis | Acute suppurative thyroiditis is an uncommon thyroid disorder usually caused by bacterial infection. |
Cause of thyrotoxicosis | TSH receptor antibodies | Thyroid US | Color flow Doppler | Radioactive iodine uptake/Scan | Other features |
---|---|---|---|---|---|
Graves' disease | + | Hypoechoic pattern | ? | ? | Ophthalmopathy, dermopathy, acropachy |
Toxic nodular goiter | - | Multiple nodules | - | Hot nodules at thyroid scan | - |
Toxic adenoma | - | Single nodule | - | Hot nodule | - |
Subacute thyroiditis | - | Heterogeneous hypoechoic areas | Reduced/absent flow | ? | Neck pain, fever, and elevated inflammatory index |
Painless thyroiditis | - | Hypoechoic pattern | Reduced/absent flow | ? | - |
Amiodarone induced thyroiditis-Type 1 | - | Diffuse or nodular goiter | ?/Normal/? | ? but higher than in Type 2 | High urinary iodine |
Amiodarone induced thyroiditis-Type 2 | - | Normal | Absent | ?/absent | High urinary iodine |
Central hyperthyroidism | - | Diffuse or nodular goiter | Normal/? | ? | Inappropriately normal or high TSH |
Trophoblastic disease | - | Diffuse or nodular goiter | Normal/? | ? | - |
Factitious thyrotoxicosis | - | Variable | Reduced/absent flow | ? | ? Serum thyroglobulin |
Struma ovarii | - | Variable | Reduced/absent flow | ? | Abdominal RAIU |
Preferred Table
Diseases | Laboratory Findings | Physical Examination | History and Symptoms | Other Findings | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Lab Test 1 | Lab Test 2 | Lab Test 3 | Lab Test 4 | Physical Finding 1 | Physical Finding 2 | Physical Finding 3 | Physical Finding 4 | Finding 1 | Finding 2 | Finding 3 | Finding 4 | ||
Differential Diagnosis 1 | + | ||||||||||||
Differential Diagnosis 2 | ↑ | - | |||||||||||
Differential Diagnosis 3 | ↓ | ||||||||||||
Differential Diagnosis 4 | |||||||||||||
Differential Diagnosis 5 |
Use if the above table can not be made
Differential Diagnosis | Similar Features | Differentiating Features |
---|---|---|
Differential 1 |
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Differential 2 |
|
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Differential 3 |
|
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Differential 4 |
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Differential 5 |
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References
- ↑ Thyroid adenoma. Wikipedia. https://en.wikipedia.org/wiki/Thyroid_adenoma Accessed on October 11, 2015