Pediatric Graves Disease

  • Etiology: Autoimmune thyroiditis resulting in antibody-directed stimulation of the thyroid-stimulating hormone receptor with production and release of T3 and T4 resulting in hyperthyroidism
  • Imaging US: Thyroid gland enlarged, hyperechoic, heterogenous, without nodules
  • Imaging US Color Doppler: Hypervascular (thyroid inferno sign)
  • DDX:
  • Complications: Increased risk of thyroid cancer
  • Treatment:
    — Antithyroid medications are first-line treatment
    — Radioactive iodine or thyroidectomy in medication-resistant patients
  • Clinical: TSH suppressed, T4 elevated, T3 elevated, TSH receptor antibodies (TSI, TGI, TBII) positive

Radiology Cases of Graves Disease

US of Graves disease
Transverse grayscale (above), color doppler (middle), and power doppler (below) US of the thyroid show an enlarged, heterogenous and hypervascular thyroid gland.
Color doppler US of pediatric Grave disease
Contiguous transverse color doppler US of the thyroid gland show the thyroid to be enlarged, hyperechoic, heterogenous, without nodules and hypervascular (thyroid inferno sign).