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Subacute Thyroiditis — RACP Adult Medicine MCQ

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ModerateEndocrinologySubacute ThyroiditisRACP Adult Medicine

A 42-year-old woman presents with neck pain radiating to the jaw, fever, and thyrotoxicosis symptoms following a viral upper respiratory tract infection. The thyroid is exquisitely tender on palpation. ESR is 65 mm/hr. Thyroid uptake scan shows diffusely reduced uptake. What is the most likely diagnosis?

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Correct answer: E — Subacute (de Quervain) thyroiditis

Painful thyroiditis following URTI with tender thyroid, elevated ESR, and low radioiodine uptake (due to follicular destruction rather than hormone synthesis) is classic for subacute (de Quervain) thyroiditis. It is self-limiting with a thyrotoxic phase followed by hypothyroid and recovery phases. NSAIDs or prednisolone for pain management.

Reference: ESA – 2024 – Thyroid Guidelines; eTG Endocrine 2024