Cracking thyroid

Last revised by Ciléin Kearns on 2 Dec 2023

Cracking thyroid is a term given to a very rare complication of thyroid fine needle aspiration (FNA) biopsy where there is acute pain and transient but marked thyroid swelling characterized by hypoechoic avascular septations on ultrasound 1,2. Onset is within a few minutes to a few hours post procedure, and thyroid volume can temporarily increase up to threefold but is self limiting 1,2. In one series, the complication was suggested to occur in 0.1% of cases 2,3. Although simple analgesia, cooling packs, and steroids have been used to treat, there is no evidence they change the duration of symptoms. Ultrasound appearances usually resolve within a few hours, but symptoms may persist longer 1-3.

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