First examination (1st and 2nd rows of images):

Clinical presentation: a 45-year-old man was referred for an evaluation with typical complaints of subacute thyroiditis: fever, pain in the region of the thyroid lasting for 2 months .

Palpation: both thyroids were firm and painful.

Functional state: moderate degree of hyperthyroidism with TSH-level 0.001 mIU/L, FT4 29.1 pM/L. ESR was 70 mm/H while CRP 20.8 mg/L.

Ultrasonography: there were multiple hypoechogenic areas with blurred borders within echonormal background. The vascularization was decreased.

Cytological diagnosis: subacute, granulomatous de Quervain's thyroiditis.

Suggestion: steroid therapy.

Follow-up examination 4 weeks later (3rd row of images):

He had no complaints with euthyroid hormone levels (TSH 2.41 mIU/L, FT4 14.1 pM/L) and normal CRP (1.1 mg/L) and ESR 9 mm/H.

Ultrasonography demonstrated an almost complete normalization.