Clinical presentation: a 47-year-old woman was presented with a 3-week history of typical complaints of subacute thyroiditis: pain in the right side of the neck, fever and signs suggesting hyperthyroidism. On ultrasound examination, she was told to have a "very suspicious nodule in the right thyroid".

Palpation: both thyroids were hard and the right was painful.

Functional state: hyperthyroidism with TSH-level 0.001 mIU/L, FT4 48.9 pM/L, CRP 12.9 mg/L.

Ultrasonography: the right thyroid was echonormal with several hypoechogenic areas with blurred borders. The hypoechogenic areas were avascular. The left thyroid was hypoechogenic.

Cytology: was performed form the largest hypoechogenic lesion in the right lobe and resulted in subacute, granulomatous de Quervain's thyroiditis.

Suggestion: steroid therapy.

The complaints of the patient ceased within 24 hours. She required 3 courses of steroid because her complaints recurred at the time of the discontinuation of steroid. Four months after the third 6-week session of steroid, the patient was well and free of complaints.

Comment: it is best to avoid commenting the ultrasonography by a person who is not familiar with thyroid disorders. Being familiar with thyroid disorders,  the sonographic, also the endocrinological, cytological, pathological aspects of the organ have to be considered. This was not the first patient in our practice who had de Quervain's thyroiditis and the radiologist caused absolutely unnecessary anxiety to the patient by misinterpreting a hypoechogenic lesion with blurred borders as carcinoma.