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Sclerosing Thyroiditis (Riedel’s Thyroiditis) : Clinical Features

المؤلف:  Wass, J. A. H., Arlt, W., & Semple, R. K. (Eds.).

المصدر:  Oxford Textbook of Endocrinology and Diabetes

الجزء والصفحة:  3rd edition , p450

2026-04-11

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The age of onset varies between 25 and 81 years, although most cases are diagnosed in the fourth to sixth decades. The female to male ratio is about 4:1.

The clinical presentation is of a painless goitre that is gradually or rapidly enlarging; constitutional symptoms of inflammation are rare. The extensive fibrosis is progressive and may eventually cause compression of adjacent structures, particularly the trachea and oesophagus. Local compressive symptoms include a marked sense of pressure or severe dyspnoea, with symptoms out of proportion to the size of the goitre. Hoarseness may result if there is involvement of the recurrent laryngeal nerve. In some patients, the fibrotic process affects the entire gland causing hypothyroidism; the prevalence of hypothyroidism in this population is between 25 and 80%. Hypoparathyroidism can develop when parathyroid gland in filtration occurs.

On examination, the thyroid gland is stony hard, often described as ‘woody’ in texture, densely adherent to adjacent cervical structures (such as muscles, blood vessels, and nerves), and may move poorly on swallowing. The lesion may be limited to one lobe. It has a harder consistency than a carcinoma and is usually non- tender. Although adjacent lymph nodes are only occasionally enlarged, when they are present a diagnosis of carcinoma is often suspected.