ABSTRACT
Subacute thyroiditis is an inflammatory disease of the thyroid gland, most probably preceded by viral infection. Common symptoms include fever, thyroid tenderness associated pain, and initial hyperthyroidism sometimes followed by a transient period of hypothyroidism with generally favourable outcomes as self-limited entity. It was known that it may be confused with pharyngitis; however search on Medline using key words (dental pain, subacute thyroiditis, and differential diagnosis) in combination recently produced no reports. Herein, we report a case of subacute thyroiditis associated pain, which was initially mistaken and treated as pain of dental origin after otorhinolaryngologic examination revealed no pathology. The aim of this communication is to remind that thyroiditis as part of differential diagnosis should be considered in patients with unexplained dental pain to avoid unnecessary diagnostic procedures, which increase expenses and may delay appropriate therapeutic measures.
Subject(s)
Thyroiditis, Subacute/diagnosis , Toothache/diagnosis , Adult , Diagnosis, Differential , Humans , MaleABSTRACT
The authors present the case of a 49-year-old female patient who was admitted with the diagnosis of ischaemic heart disease and the syndrome of angina pectoris grade IV for selective coronarography. For assessment of the affection of one artery, significant stenosis of the insertion of the ramus interventricularis anterior the authors indicated a bypass of the left mammary artery to the ramus interventricularis anterior. During the postoperative course the patient did not have any anginous symptoms or any other clinical signs suggesting ischaemia or necrosis of the heart muscle. During the ultrasonographic check-up examination of the mammarocoronary bypass the suspicion of occlusion of the graft was expressed and this was confirmed on angiography. An angiographically successful percutaneous transluminal angioplasty of occlusion of the bypass was made. During the subsequent ultrasonographic examination the authors suspected again graft occlusion and angiography confirmed a 90% stenosis. Therefore the patient was re-operated. It appears that ultrasonographic examination of the mammacoronary bypass may prove useful in the diagnosis of occlusion or critical stenosis of a graft.
