HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

What Causes Painful Bulge On Neck Despite Having Eltroxin For Thyroid Disorder?

Posted on Wed, 7 Jan 2015

Question: Hello,
I was recently diagnosed with Thyroid and put on Eltroxin. I am also taking Vitamin b12 and Vitamin d3 supplements. A few days ago, I noticed a painful bulge on the right handside of my neck extending towards the ear. Upon consultation with my physician, I was asked to undego a Doppler of my neck to check on the Carotid and Vertebral Arteries. The test was normal and my physician diagnosed it as Pharyngitis and put me on paracetmol to help with the inflamation.

I have been taking the meds for two days now. However, since this evening I feel the inflamation has worsened, become more painful and I have a constant buzz in my ear. Upon feeling the right handside of my neck, I can tell its bigger and heavier than the other end. Also, the bulge feels alot more raw than it did before and has extended towards the top side towards my ear.

Can Pharyngitis actually cause symptoms like this? Also, I am concerned if this can extend towards my brain and lead to complications. Is there any test that can help confirm if this inflamation is linked to a throat infection, caused by my recent thyroid diagnosis or is a blood clot or an aneurysm? Any help here would be much appreciated.

Thanks!

Answered by Dr. Ajish TP (5 hours later)

Brief Answer:
Do an MRI neck if in doubt

Detailed Answer:
Hi XXXXXX,

Thanks for posting questions in HCM.

Don't worry, aneurysm and clots are very rare in your age group. Since the doppler is normal these diagnosis are unlikely.

If the swelling is increasing in size and painful, most probably it is an infection. The common infective swelling is a lymph node infection. This enlarged lymph node could be due to pharyngitis or infection in oral cavity or anywhere in your head.

Please consult your physician and do a further evaluation. If I were your treating physician I would have ordered a complete blood count, C-reactive protein and blood culture which will help you to say it is an infection or not. Most probably you might have to be started on antibiotics which will settle the infection in a weeks time.

For the swelling in neck what we usually do an ultrasound scan of neck and if inconclusive do an MRI scan of neck, which will clearly say the size and extend of the swelling.

This is unlikely to be related to thyroid or aneurysm.

Hope I have answered your question. If you have any further questions I will be happy to help.

Regards
Dr Ajish TP
Consultant Endocrinologist

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ajish TP (4 hours later)

Thanks for your answer. By MRI of the neck do you mean a cervical and spine MRI? Also is there anything in particular you'd like me to ask the doc to look out for during the scan?

Answered by Dr. Ajish TP (1 hour later)

Brief Answer:
MRI neck (same as cervical spine)

Detailed Answer:
Hi XXXXXX,

Welcome back.

The MRI of neck will show the entire soft tissue of neck. Just inform the doctor where you are having the swelling and that entire area will be scanned. The details like size, extend, type of swelling can be made out in MRI.

If there is swelling the doctor can help you with a scan guided FNAC (Needle biopsy) which can give you the diagnosis.

Wishing you good health

Regards

Dr Ajish TP

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari