Imaging of thyrotoxicosis.

The diagnostic algorithm for patients with Graves' disease frequently involves the use of thyroid autoantibody testing and radioisotope scanning (full text available online: http://education.amjmed.com/pp1/248). However, ultrasound has myriad uses in the evaluation of patients with hyperthyroidism. The purpose of this paper is to review the medical literature outlining the important role that ultrasonography (US) can play in the diagnosis and management of patients with hyperthyroidism. We will make a case for the use of ultrasonography in the initial evaluation of all patients with thyrotoxicosis. This review will delineate the advantages of ultrasonography compared to nuclear medicine imaging in determining the etiology of the hyperthyroidism. The role of sonography in predicting remission and relapse of Graves' disease will also be examined. Finally, this paper will detail the importance of ultrasonography in the workup of hyperthyroidism during pregnancy. We will also outline its utility for predicting fetal thyroid dysfunction in maternal Graves' disease without the need for cordocentesis and its attendant complications.