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Friday, 29 November 2013

Thyroid Disease : Acute thyroiditis – The Diagnosis

Thyroid disease is defined as a condition of malfunction of thyroid. Hyperthyroidism is a condition in which the thyroid gland is over active and produces too much thyroid hormones. Hypothyroidism is a condition in which the thyroid gland is under active and produces very little thyroid hormones. Thyroid cancer is defined as condition in which the cells in the thyroid gland have become cancerous.
Acute thyroiditis (Acute infectious thyroiditis or acute suppurative thyroiditis) is defined as a condition of as a result of relatively high amount of iodine in the tissue causes of microbial inflammatory thyroiditis, pyrogenic thyroiditis and bacterial thyroiditis. Acute infectious thyroiditis is very rare, accounting for about 0.1-0.7% of all thyroiditis.
D.2. Diagnosis
If you are experience certain symptoms of the above and your doctor suspects that you have developed acute thyroiditis, after recording the past and present history and completing a physical exam, including assessing symptoms and complaints commonly seen including enlarged thyroid gland, heart rate, shaking hand etc., the tests which your doctor orders may include
1. Blood test
The aim of the test is to check for the elevation of white blood cell count, erythrocyte sedimentation rate, abnormal thyroid hormone levels and lkaline phosphatase, transaminases increased(26).
2. Needle aspiration
Needle aspiration is a diagnostic procedure used to investigate superficial (just under the skin) lumps or masses. . Acute suppurative thyroiditis after fine-needle aspiration (FNA) in an immunocompetent patient is very rare. We report the case of a 50-year-old immunocompetent male patient who presented with painful cervical swelling, fever, and chills after an FNA of the thyroid. His physical and laboratory examination suggested an acute suppurative thyroiditis. Repeat FNA results were consistent with thyroid abscess. Physicians should be aware of the probability of acute bacterial thyroiditis after FNA, according to the study by the Ankara University School of Medicine(27).
3. Ultrasound and oesophagography
The thyroid is remarkably resistant to infection. Hence, when an infection does occur, the presence of a pyriform fossa sinus must be considered. The Prince of Wales Hospital, presents the role of ultrasound and oesophagography in five children with pyriform fossa sinus associated with suppurative thyroiditis. In four children the abnormality was on the left and on the right in one(28).
4. CT scan
CT scan can be useful in identifying the location of the abscess, but this has been said to be required only in unusual situations.
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Sources
(26) http://www.uptomed.ir/Digimed.ir/WilliamsTextbookOfEndocrinology/WilliamsTextbookOfEndocrinology/HTML/72.htm
(27) http://www.ncbi.nlm.nih.gov/pubmed/23893617
(28) http://www.ncbi.nlm.nih.gov/pubmed/9528872