Ultrasound-Guided Capsular Thyroid Injection Therapy With Dexamethasone and Lidocaine Mixture for Subacute Thyroiditis: A Single-Center Study

J Ultrasound Med. 2023 Feb;42(3):613-621. doi: 10.1002/jum.16054. Epub 2022 Sep 3.

Abstract

Objectives: Subacute thyroiditis (SAT) is a self-limiting, inflammatory thyroid disease possibly caused by viral infection. In recent years, the incidence of SAT is increasing, especially during the pandemic of the COVID-19. This study aimed to evaluate the efficacy, safety, and recovery time of capsular thyroid injection therapy under ultrasound guidance for SAT.

Methods: A total of 73 patients with SAT were divided into two groups. Patients in group A (n = 48) received an ultrasound-guided capsular injection consisting of dexamethasone (DEX) and lidocaine in the thyroid lesion area, while patients in group B (n = 25) received oral prednisolone (PSL). The two groups were compared for pain relief and treatment duration, the recovery time of thyroid function, recurrence rates, hypothyroidism incidence, and drug-related side effects.

Results: The follow-up time was 1 year. In group A, the duration of pain relief, treatment, and recovery time of thyroid function were significantly shorter than that in group B (P < .05), and no statistically significant differences in recurrence rate or incidence of hypothyroidism were observed (P > .05). Weight gain was significantly higher in group A at the end of treatment (P < .001).

Conclusions: Compared with oral PSL treatment, ultrasound-guided local injection of DEX and lidocaine into the capsular thyroid is a safe and effective procedure that can significantly reduce the treatment time of SAT.

Keywords: dexamethasone; injection therapy; prednisolone; subacute thyroiditis; ultrasound.

MeSH terms

  • COVID-19 Drug Treatment
  • COVID-19* / complications
  • Dexamethasone / therapeutic use
  • Humans
  • Hypothyroidism* / drug therapy
  • Hypothyroidism* / etiology
  • Lidocaine
  • Pain / drug therapy
  • Thyroiditis, Subacute* / diagnostic imaging
  • Thyroiditis, Subacute* / drug therapy
  • Thyroiditis, Subacute* / pathology
  • Ultrasonography, Interventional

Substances

  • Lidocaine
  • Dexamethasone