First examination (first row):

Clinical presentation: a 27-year-old woman was referred for an evaluation of typical complaints suggesting hypothyroidism.

Palpation: both lobes were very firm on palpation.

Functional state: hypothyroidism TSH 132.4 mIU/L, FT4 3.75 pM/L.

Ultrasonography: the thyroid was moderately hypoechogenic and inhomogeneous. The vascularization was increased. There were no discrete lesions.

100 microgram levo-tiroxine was advised.

Follow-up investigation 3 months later (second row):

Clinical presentation: the patient had no complaints.

Palpation: unchanged.

Functional state: euthyroidism on daily 100 microgram levothyroxine: TSH 0.29 mIU/L, FT4 17.6 pM/L.

Ultrasonography: the size of the thyroid and the vascularization decreased.

Follow-up investigation 9 months after the initial (third row):

Clinical presentation: the patient had no complaints.

Palpation: unchanged.

Functional state: euthyroidism on daily 100 microgram levothyroxine: TSH 1.46 mIU/L.

Ultrasonography: the size of the thyroid and the vascularization decreased further as did the degree of hypoechogenicity.