Presentation
Patient presented with a suppressed TSH.
Patient Data
Tc-99m pertechnetate scan
Thyroid scintigraphy performed 20 minutes after the administration of 11 mCi of Tc99m-pertechnetate IV shows no significant uptake in the thyroid/central neck.
Ultrasound of the thyroid shows and enlarged, heterogeneous and hyper vascular gland without focal lesion.
Case Discussion
Thyroid uptake of Tc-99m pertechnetate is closely correlated with radioiodine uptake in most patients, despite the fact that pertechnetate does not undergo organification by follicular cells like iodine.
Uptake of the radiotracer by the thyroid can be compared to that of the salivary glands (less than, equal to, or more than salivary glands).
In the setting of Graves’ or toxic nodular goiter, the thyroid gland will be easily visualized in greater than or equal to the salivary glands, whereas thyroid gland will be non- or poorly visualized and less intense than the salivary glands in subacute thyroiditis (as in this instance).
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