Introduction
- Hyperthyroidism is diagnosed when there is elevation of serum free T3 and/or T4 accompanied by typical symptoms and signs. Biochemical evidence without clinical manifestations is referred to as subclinical hyperthyroidism. 9
- Common causes of hyperthyroidism include Graves' disease, toxic multinodular goitre, functioning thyroid adenoma and thyroiditis.10
- The role of imaging in hyperthyroidism is to help establish the cause and this is usually done with a thyroid scintigraphy scan.
- Elevated T3 and T4 is usually accompanied by low levels of TSH. However, rarely hyperthyroidism is driven by high TSH levels in which case a TSH-secreting pituitary adenoma should be excluded.
- Typical cases of Graves' disease such as those with a diffuse goitre, ophthalmopathy and serological evidence may treated without any prior imaging although scintigraphy may help confirm the diagnosis and exclude other causes.
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