Case Author(s): Edward Pinkus,M.D. and Jerold Waliis,M , 12/24/01 . Rating: #D., #Q.

Diagnosis: Grave disease

Brief history:

43 year old female with exophtalmus,agitated,elevated Free T-4,undetectable TSH level was presented to evaluate thyroid pathology. And to differentiate thyroiditis vs. Grave's disease.


thyroid scintiigraphy

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Full history/Diagnosis is available below

Diagnosis: Grave disease

Full history:

43 year old female with exophtalmus, agitated, elevated free T4, undetectable TSH was presented to evaluate thyroud pathalogy and differentiate thyroiditis vs. Grave disease. Thyroid gland on physical exam 35-40 grams.


10.1 mci Tc-99m pertechnetate i.v.


Uniformly increased activity in the both lobes of the enlarged thyroid gland. There is no evidence of nodular increased activity to suggest a toxic nodular goiter, nor decreased uptake to suggest thyroiditis. Findings consistent with hyperthyroidism due to Grave disease.


Grave disease is of autoimmune origin. It presents with thyromegaly, uniform distribution of incresed activity throughout the tyroid gland, and with prominent pyramidal lobe. On Tc-99m petechnetate scan,the thyroid has increased activity, and salivary glands are difficukt to identify. 24-hour iodine uptake usually in the range of 40-70%.


On 2/28/02 24-hour radioactive iodine uptake was 66%. She was treated with 7.1 mci of I-131.

ACR Codes and Keywords:

References and General Discussion of Thyroid Scintigraphy (Anatomic field:Face, Mastoids, and Neck, Category:Metabolic, endocrine, toxic)

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Case number: tr012

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