Thyrotoxic periodic paralysis: sonographic appearances of the thyroid.
OBJECTIVE
The aim of the study was to describe the sonographic appearances of the thyroid in patients with thyrotoxic periodic paralysis (TPP).


METHODS
Of the 25 patients diagnosed with TPP between January 1, 1998, and December 31, 2001, as identified by a search of our patient database, 13 had undergone sonography of the thyroid. We retrospectively reviewed the clinical records and thyroid sonograms of these 13 patients. The sonograms were assessed subjectively for thyroid size, echogenicity, vascularity, and the presence of solid nodules and cysts.


RESULTS
Sonography showed abnormality of the thyroid in all 13 patients. In 11 patients (85%), sonography showed widespread hypoechogenicity (compared with the muscle) whose distribution was diffuse (6 patients) or patchy (5 patients) and diffusely distributed areas of hypervascularity (type 1 pattern). All 11 of these patients had a clinical diagnosis of Graves' disease. One patient (8%) had multinodular goiter and enlargement of the thyroid with multiple heterogeneous solid nodules and cysts (type 2 pattern); the clinical diagnosis was toxic multinodal goiter. One patient (8%) had a combination of type 1 and type 2 patterns and a clinical diagnosis of Graves' disease.


CONCLUSIONS
The sonographic abnormalities of the thyroid in patients with TPP reflect the common underlying causes of thyrotoxicosis in the general population. The sonographic appearances associated with Graves' disease (type 1 pattern) were the most common abnormality detected. No sonographic features specific to TPP were identified.
King
Ann D
AD
Department of Diagnostic Radiology and Organ Imaging, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, 30-33 Ngan Shing Street, Shatin, New Territories, Hong Kong.
Chow
Francis C C
FC
Ahuja
Anil T
AT
Richards
Polly S
PS
D000328:Adult; D006111:Graves Disease / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D010245:Paralyses, Familial Periodic / Q000000981:diagnostic imaging / Q000209:etiology*; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000000981:diagnostic imaging*; D014463:Ultrasonography