Our latest case report from Brady Pregerson, MD, featuresa woman in her mid-60s with a history of Hashimoto’s thyroiditis treated with levothyroxine presenting to the hospital with 4-5 days of pain, swelling and redness on her left thumb.
History of Present Illness:
A patient in their mid-60s, with a history of Hashimoto’s thyroiditis using levothyroxine, presents to the hospital with 4 to 5 days of pain, swelling, and redness on her left thumb. She states that the pain is actually slightly better today than it was yesterday. She denies any trauma, fever, or other complaints. She does say about 3 weeks ago she had a small cut in that area that healed uneventfully within 4-5 days. She has no other complaints.
Vital Signs and Physical Exam:
Vital signs are normal. Physical exam is also normal except for the thumb. See image below:
Initial Diagnostic Testing:
CBC and Chem-7: Normal
Imaging: Bedside water bath ultrasound shows a slightly hyperechoic mass without shadowing that does not compress. X-ray is shown below.
What is the most likely diagnosis?