Presentation
An enlarged neck swelling.
Patient Data
![](https://prod-images-static.radiopaedia.org/images/546361/9d040735e15cfa69a9fee26be08416_thumb.jpg)
![](https://prod-images-static.radiopaedia.org/images/546362/163a4a4c7171050341d0510a5e5d15_thumb.jpg)
![](https://prod-images-static.radiopaedia.org/images/546363/f0c69534100632d7c0315b93c2a1ba_thumb.jpg)
![](https://prod-images-static.radiopaedia.org/images/546361/9d040735e15cfa69a9fee26be08416_big_gallery.jpg)
The thyroid gland is diffusely enlarged and hypoechoic with a slightly lobulated contour. Color Doppler demonstrates a diffusely increased vascular flow in the thyroid gland, a phenomenon also known as "thyroid inferno".
Case Discussion
Graves disease is a common diffuse abnormality of the thyroid gland usually characterized by thyrotoxicosis. With color Doppler, most Graves disease patients show a pulsatile pattern better known as thyroid inferno. This pattern consists of multiple small areas of intrathyroidal flow seen diffusely throughout the gland. This hypervascularity is due to arteriovenous shunts in the thyroid gland.