Differential Diagnosis for a 38-year-old Female with Throat Pain, Anterior Cervical Tenderness, and Diffusely Enlarged Thyroid Gland
- Single most likely diagnosis:
- Subacute Thyroiditis: This condition is characterized by inflammation of the thyroid gland, leading to pain, tenderness, and a diffusely enlarged thyroid gland. The symptoms presented, such as throat pain and anterior cervical tenderness, are consistent with this diagnosis. It often follows a viral infection, which could explain the acute onset.
- Other Likely diagnoses:
- Acute Thyroiditis: Although less common, acute thyroiditis can present with similar symptoms, including pain and tenderness of the thyroid gland. It is usually caused by a bacterial or fungal infection.
- Hashimoto Thyroiditis: This is an autoimmune condition that can cause thyroid gland enlargement and tenderness. However, it typically has a more gradual onset and is often associated with hypothyroidism.
- De Quervain Thyroiditis: A form of subacute thyroiditis, it is characterized by a painful thyroid gland and is often triggered by a viral infection.
- Do Not Miss diagnoses:
- Thyroid Cancer: Although less likely, thyroid cancer can cause an enlarged thyroid gland and should not be missed due to its potential severity. Pain and tenderness are less common presentations but can occur, especially if there is involvement of surrounding structures.
- Infectious Thyroiditis (bacterial or fungal): These infections are rare but can be life-threatening if not promptly treated. They can present with severe pain, tenderness, and systemic signs of infection.
- Rare diagnoses:
- Riedel Thyroiditis: A rare form of chronic thyroiditis characterized by a hard, fibrotic thyroid gland that can cause compressive symptoms. It is very rare and usually presents with a hard, non-tender goiter.
- Sarcoidosis involving the thyroid: Sarcoidosis is a systemic disease that can rarely involve the thyroid gland, causing enlargement and potentially other symptoms. It would be an unusual presentation for sarcoidosis but should be considered in the differential diagnosis of a diffusely enlarged thyroid gland with systemic symptoms.