History and exam
Key diagnostic factors
common
neck pain
Pain of the anterior neck may range from moderate to severe, accompanied by an inability to swallow or tolerate a physical exam. The pain may sometimes radiate to the ears or jaw.
tender, firm, enlarged thyroid
The thyroid is often enlarged, firm, and tender to palpation.[15]
fever
Approximately 30% of patients have a temperature between 98.6°F (37°C) and 100.4°F (38°C). Another 30% of patients have fever >100.4°F (38°C).[1]
palpitations
Palpitations may occur in >70% of patients who have symptoms of thyrotoxicosis.[1]
This is caused by fever and high circulating thyroid hormone levels.
Other diagnostic factors
common
recent viral infection
Approximately 25% to 30% of patients report a viral infection within 1 month before the onset of subacute thyroiditis.[1]
myalgia
Myalgia may resemble that of a systemic viral illness.
malaise
Malaise may be caused by a viral infection, and can be seen in association with fever and high circulating thyroid hormone levels.
tremor
Tremors may be caused by high circulating thyroid hormone levels.
heat intolerance
Heat intolerance may be caused by fever and high circulating thyroid hormone levels.
Risk factors
strong
viral infection
Approximately 30% to 40% of patients with subacute thyroiditis describe a viral infection within one month of onset. The peak incidence coincides with the summer to fall seasons, which is the peak incidence of many other viral infections. Viral antibody titers tend to be high at the onset of the illness and fall with time.[8][9]
Certain HLA and B35 alleles
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