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What Causes Shoulder Blades And Back Pain, Swollen Lymph Nodes On Neck?

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Posted on Fri, 10 Jul 2015
Question: Hi I have been very sick for over a year. Symptoms include painful swollen lymph nodes on neck and throat. I have horrible pain in my back and shoulder blades. A CT scan was conducted and said I had a goiter and lymph nodes. It reported reactive lymph nodes with in the anterior and posterior cervical chain bilaterally. mild thyromegaly. Also indicating multinodule goiters. The radiologist suggested fine needle aspiration and NM Thyroid imaging with uptake and sonogram. NM results reported poor uptake of radiotracer in the thyroid gland which measured only 1.7%. Impression reported Hypothyrodism and findings of subacute granulomatous thyroiditis or Hashimoto's Disease. Ultra Sound reported innumerable hypoechoic micronodules (1 to 6mm) with surrounding echogenic septations. Englarged reactive cervical level 2 and 4 lymph nodes with benign sonographic features. Impression: Subacute granulomatous thyroiditis. Report states Subacute granulomatous thyroiditis versus Hashimoto's thyroiditis, Subacute is painful Hashimoto's thyroiditis is not. I saw a surgeon and he reported no biopsy was needed. I do have an appointment with an endocrinologist next week. I am 36 years old approximately 5 ft 4 inches. When I was 11 I was diagnosed Mono and then tested positive for Epstein Barr virus. I have cuts that will not heal. I went through this last year and was told nothing was wrong with me. I went from weighing 135lbs to 109 lbs. I was advised to go to the ER. I was in the ER for five times last year. In two months time I weighed 136lbs. Now I am told to go the ER all time. I currently weigh 124lbs. I am irritable confused forgetful and in so much pain I can barely stand it. I don't understand whats going on with me. T4 1.46. T3 Free 3.70. TSH 0.11. Resting pulse 98. Mild fevers. Do you have any advice? Radiology said to get biopsy surgeon said I didn't need one. What does the above described symptoms indicate to you. Please help me.
doctor
Answered by Dr. Binu Parameswaran Pillai (6 hours later)
Brief Answer:
ENDOCRINOLOGIST IS THE BEST PERSON

Detailed Answer:
Good day dear,

Sorry to hear about your symptoms. Going throught the details, i feel you are having thyroiditis. Normally these symptoms last for 3-4 months and diasppears with a future risk of hypothyroidism. The ultrasound appearance is very typical of thyroiditis " Innumerable hypoechoic micronodules (1 to 6mm) with surrounding echogenic septations. Englarged reactive cervical level 2 and 4 lymph nodes with benign sonographic features"".

However, a physical examination and few blood tests would be required.
Ususally a needle test is required if there is a nodule of more than 1 cm in size. Very rarely, we do have to do needle test in thyroiditis to rule out rare infiltrative disorders.

I WOULD SAY, RATHER THAN A SURGEON OR RADIOLOGST, an ENDOCRINOLOGIST is the best person to evaluate you further. Please wait till you see your endocrinologist. In the interim, you can take pain killers. If possible, please get an ANTI TPO antibody and Anti Thyroglobulin antibody tests. These are blood tests.

Regards
Binu


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (15 hours later)
Thank you for your answer. I'm Currently am in so much pain and feel like I have flu/mono but test say hyperthyroidism and I sho have energy but I don't. I want to go urgent care but idk if they can do anything for me. My goiter is very painful and hard to swallow. I feel so very sick. My whole body hurts. My ears and throat feel like knives going in them
doctor
Answered by Dr. Binu Parameswaran Pillai (18 hours later)
Brief Answer:
Pain killers or Steroids will help

Detailed Answer:
Sorry for the delay. I was travelling.
It looks like as if you have a viral thyroiditis. You need to take pain killers ( Ibuprofen or Voltaren). If no relief, then you may need few days course of steroids.

As i mentioned earlier, this phase will eventually pass off.
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. Chakravarthy Mazumdar
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Answered by
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Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1439 Questions

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What Causes Shoulder Blades And Back Pain, Swollen Lymph Nodes On Neck?

Brief Answer: ENDOCRINOLOGIST IS THE BEST PERSON Detailed Answer: Good day dear, Sorry to hear about your symptoms. Going throught the details, i feel you are having thyroiditis. Normally these symptoms last for 3-4 months and diasppears with a future risk of hypothyroidism. The ultrasound appearance is very typical of thyroiditis " Innumerable hypoechoic micronodules (1 to 6mm) with surrounding echogenic septations. Englarged reactive cervical level 2 and 4 lymph nodes with benign sonographic features"". However, a physical examination and few blood tests would be required. Ususally a needle test is required if there is a nodule of more than 1 cm in size. Very rarely, we do have to do needle test in thyroiditis to rule out rare infiltrative disorders. I WOULD SAY, RATHER THAN A SURGEON OR RADIOLOGST, an ENDOCRINOLOGIST is the best person to evaluate you further. Please wait till you see your endocrinologist. In the interim, you can take pain killers. If possible, please get an ANTI TPO antibody and Anti Thyroglobulin antibody tests. These are blood tests. Regards Binu