title: Discovery of unsuspected thyroid pathologic conditions after trauma to the anterior neck area attributable to a motor vehicle accident: relationship to use of the shoulder harness.
abstract: OBJECTIVE
  To alert physicians to the possibility of antecedent trauma to the neck in patients presenting with a thyroid nodule or with symptoms and signs related to the thyroid gland.
  
  
  METHODS
  We present five case reports in which the cause of thyroid nodular disease was suspected to have been trauma to the anterior neck area during an earlier motor vehicle accident in which the shoulder harness impacted the neck.
  
  
  RESULTS
  In five female patients, shoulder harness trauma from an automobile accident led to the subsequent discovery of a thyroid lesion. Four of the five patients underwent surgical removal of the thyroid nodule. Although traumatic injury of the thyroid may be common, we found only one report in the medical literature regarding the discovery of a thyroid nodule or thyroiditis in the setting of traffic accident-related trauma to the thyroid gland.
  
  
  CONCLUSIONS
  In the initial assessment of patients with thyroid nodular disease, we emphasize the importance of obtaining a detailed and comprehensive history, including inquiry about trauma to the neck. Prompt diagnostic accuracy will help avoid unnecessary costs and risks in the workup of such patients.
authors.affiliation: Piedmont Pathology, Hickory, North Carolina, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Dickey
authors.forename: James L
authors.initials: JL
authors.lastname: Parker
authors.forename: Stanley
authors.initials: S
authors.lastname: Feld
mesh_terms: D000063:Accidents, Traffic; D000236:Adenoma / Q000209:etiology / Q000473:pathology / Q000601:surgery; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D019838:Neck Injuries / Q000473:pathology*; D012622:Seat Belts / Q000009:adverse effects*; D013961:Thyroid Gland / Q000293:injuries* / Q000601:surgery; D016606:Thyroid Nodule / Q000209:etiology / Q000473:pathology / Q000601:surgery; D013966:Thyroiditis / Q000209:etiology / Q000473:pathology