Which thyroiditis is associated with a painful and tender thyroid, often following an upper respiratory viral illness?

Which thyroiditis is associated with a painful and tender thyroid, often following an upper respiratory viral illness?

• A. Hashimoto thyroiditis.
• B. Graves disease.
• C. Riedel thyroiditis.
• D. Subacute thyroiditis.

Answer: (D)

Subacute thyroiditis presents with a painful, tender thyroid that often follows a viral upper respiratory infection. The inflammation causes thyroid pain and fever, and many patients experience a transient thyrotoxic phase as thyroid hormone stored in the gland is released. This can be followed by a period of hypothyroidism before full recovery. Lab clues include elevated inflammatory markers such as ESR and CRP, and thyroid function tests may show thyrotoxicosis early on with eventual normalization. Management focuses on symptom relief with NSAIDs or aspirin, and short courses of steroids for more severe pain; beta-blockers can help control tachycardia or palpitations during the thyrotoxic phase. The course is typically self-limited over weeks to months. Other thyroiditis types are usually not painful or are not linked to a preceding viral illness—for example, Hashimoto is typically painless and autoimmune, Graves causes hyperthyroidism with characteristic eye findings, and Riedel is a hard, fixed goiter without the post-viral inflammatory pattern.

Subacute thyroiditis presents with a painful, tender thyroid that often follows a viral upper respiratory infection. The inflammation causes thyroid pain and fever, and many patients experience a transient thyrotoxic phase as thyroid hormone stored in the gland is released. This can be followed by a period of hypothyroidism before full recovery. Lab clues include elevated inflammatory markers such as ESR and CRP, and thyroid function tests may show thyrotoxicosis early on with eventual normalization. Management focuses on symptom relief with NSAIDs or aspirin, and short courses of steroids for more severe pain; beta-blockers can help control tachycardia or palpitations during the thyrotoxic phase. The course is typically self-limited over weeks to months. Other thyroiditis types are usually not painful or are not linked to a preceding viral illness—for example, Hashimoto is typically painless and autoimmune, Graves causes hyperthyroidism with characteristic eye findings, and Riedel is a hard, fixed goiter without the post-viral inflammatory pattern.