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

Clinical presentation: a 44-year-old man was referred with typical complaints of subacute thyroiditis: fever, pain in the region of the thyroid lasting for 2 weeks. He suffered from upper airway infection 6 weeks earlier.

Palpation: both thyroids were hard and painful.

Functional state: euthyroidism with TSH-level 0.89 mIU/L, FT4 14.7 pM/L, CRP 11.2 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. The complaints of the patient completely resolved but recurred after the discontinuation of steroid. After a repeated course of a 6-week steroid therapy, the complaints did not come back.

Follow-up examination 10 months later (3rd row of images):

He had no complaints with euthyroid hormone levels.

Ultrasonography demonstrated a complete normalization.