Importance of usg thyroid in hypothyroidism,classic usg finding of hypothyroidism??

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Thanks for tagging me Dr Ankit Hissaria. Importance of USG Thyroid is a wonderful question. I will detail it in brief. USG findings of Thyroid gland in various conditions are as follows. 1) USG of NormalThyroid gland shows tissue with interfaces display as hyperechogenic area. 2) Thyroid cyst shows anechogenic areas in USG due to full of liquid and structures with no interfaces. 3) Thyroid Ultrasound (TUS) is crucial in differencial diagnosis of Hypothyroidism particularly if Thyroid antibodies are negative. 4) In Overt Hypothyroidism , there is diffuse hypoechogenicity in TUS. 5) The most common cause of Hypothyroidism in iodine sufficient areas is Hashimotos thyroiditis usually presents with no goitre. In iodine deficiency areas Hashimotos thyroiditis mostly presents with a goitre. The typical picture of Hashimotos thyroiditis with positive antibodies in TUS is inhomogeneous , hypoechogenicity with increased vascularisation. 6) In cases with severe Hypothyroidism with TSH upto 100 mIU/ L and more which may occur e.g. after delivery ,the Thyroid gland volume increases dramatically the ultrasound image may be one of very hypoechogenic goitre with fibrotic septae- Honeycomb like. 7) In some cases with positive Anti Thyroid antibodies and Thyroid dysfunction may have normal echogenicity of parenchyma which is filled with small sharply circumscribed hypoechogenic lesions which look like Moth Eaten in TUS. 8) Atropic thyroiditis is a common variant of Hashimotos thyroiditis of long term active disease. A very small inhomogeneous Thyroid gland which may be both hypo and hyperechogenic ( in case of advanced fibrotisation) in TUS. 9) TUS is a useful diagnostic method in evaluation of risk of developing Hypothyroidism. 10) The relationship between antithyroid antibodies positivity and TUS image may change in the settings of altered hormonal status like pregnancy. The occurrence of Hypothyroidism in pregnancy and the rate of preterm delivery were linked to autoimmune pattern in TUS. Thus, a normal TUS image in a TPOAb positive euthyroid pregnant women might be a favourable predictive parameter. 11) The TUS image in post partum thyroiditis in both hyper and hypothyroid Phases includes typical autoimmune pattern - Enlargement, Inhomogeneous, hypoechogenic parenchyma with increased vascularisation. 12) Drugs like Amiodarone can cause both hyper and hypo function of thyroid gland which may develop both in normal Thyroid gland or in pre-existing Thyroid disease. The TUS image of Amiodarone induced Hypothyroidism has similar picture like in autoimmune Hashimotos thyroiditis. 13) There are limitations for TUS. Diagnosis of Thyroid disorders can be further confirmed by Radionuclide scan, FNAC Thyroid , CT scan in addition to TUS.
First of all ,i offer my respect to u mam for ur such a nice explanation by which i and readers of curofy learned that TUS has crucial role in thyroid dysfunction,we have learnt from ur answer that different causes of hypothyroidism has different blueprint in TUS,just one doubt Do sarcoidosis and other infiltrative malignancies as cause of hypothyroidism,can be ruled out by TUS and how they affect echogenicity,vascularity of thyroid gland,do sarcoidosis and infiltrative malignancies too
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USG IS IMPORTANT TO DIFFERIANTIAL DIAGNOSIS OF HYPOTHYROIDISM LIKE HASHIMOTOS THYROIDITIES POST OPERATIVE STATUS IODINE DEFICIENCY AMIDORONE INDUCED HYPOTHYROIDISM AND MANY OTHER CONDITIONS
Thank you doctor
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WITH THE.. TUS.. STUDY.. OVERACTIVE AND UNDERACTIVE .. AS WELL..THYROID PATHOLOGY .. LIKE.. HASHIMOTO'S DISEASE CAN BE STUDIED..
Thank you doctor
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