H&N Thyroid/PTH

Playlist contributed by: Dr Annabelle Skelley

Single Thyroid Lesions

  1. Adenomatous nodule = colloid nodule (may be multiple, usually hypo functioning) 

Toxic adenomatous nodule = Plummer disease -> hyperthyroidism 

  1. Follicular adenoma -> cannot differentiate from follicular Ca and needs to be resected 
  2. Thyroid cancer (papillary, follicular, medullary & anapaestic)  -> aggressive features (microcalcs, irregular, hypo echoic) 

Note: papillary -> usually present with LN involvement (cystic/necrotic) 

Diffuse Thyroid Process

  1. Hashimoto thyroiditis -> diffusely enlarged, heterogenous, hyper vascular, may have hypo echoic micro nodules; Iodine -> cold spots/reduced uptake late
  2. Toxic multi nodular goitre (hyperthyroid) -> multiple nodules, heterogenous uptake on Tc99m/I123
  3. Graves disease -> diffusely enlarged, hyper echoic, heterogeneous; nucs: homogeneous activity
  4. DeQuervain thyroiditis -> preceding URTI -> low uptake on Nucs with hyperthyroidism is almost diagnostic. 

Hyperparathyroidism

  • Primary -> parathyroid adenoma, parathyroid hyperplasia
  • Secondary: chronic hypocalcaemia (renal osteodystrophy most common)
  • Tertiary: PT adenoma caused by chronic overstimulation of hyper plastic glands in renal insufficiency
  • Acro-osteolysis
  • Subperiosteal bone resorption -> radial aspect of prox & middle 2-3 phalanges 
  • Rugger jersey spine
  • Salt & pepper skull 
  • Brown tumours 

 

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Playlist information

rID: 21129
Visibility: public

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