Autoimmune thyroid disease is a common thyroid disorder that encompasses
a number of conditions including Hashimoto’s thyroiditis, atrophic thyroiditis and
Graves’ disease. Hashimoto’s thyroiditis presents on ultrasound as a hypoechoic,
heterogeneous and asymmetrical thyroid gland. Other sonographic features of
Hashimoto’s thyroiditis are micronodulation, fibrous bands, pseudonodules,
hyperechoic regenerative thyroid nodules, and cervical lymphadenopathy especially in
the central compartment. The ultrasound features of Graves’ disease are less marked
than Hashimoto’s thyroiditis and include a diffuse goitre with reduced thyroid gland
echogenicity and increased vascularity on Doppler study. The presence of thyroid
nodules in hyperthyroid Graves’ patients requires further evaluation with thyroid
ultrasound, thyroid scintigraphy and FNA biopsy of any suspicious and
hypofunctioning nodules. Subacute (De Quervain’s) thyroiditis most probably has a
viral aetiology and patients present with a tender thyroid gland and raised inflammatory
markers. The thyroid gland displays hypoechoic areas with reduced Doppler flow on
ultrasound. On the other hand silent thyroiditis and its variant, post-partum thyroiditis,
present on thyroid ultrasound as a slightly hypoechoic and heterogeneous gland. There
are two types of amiodarone-induced hyperthyroidism, type 1 which resembles Graves’
disease with increased vascularity on Doppler study and type 2 disease that is
associated with destructive thyroiditis and normal or reduced vascularity.
Keywords: Autoimmune thyroid disease, Atrophic thyroiditis, Amiodaroneinduced
hyperthyroidism, Cervical lymphadenoathy, Fibrous bands, Graves’
disease, Hashimoto’s thyroiditis, Heterogeneous, Hypoechoic, Micronodulation,
Post-partum thyroiditis, Pseudonodules, Regenerative hyperechoic nodules, Silent
thyroiditis, Subacute thyroiditis, Thyroid inferno, Ultrasound Doppler study.
