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[Music] hi I'm Joe Langer from the Perman school of medicine at the University of Pennsylvania and my lecture is entitled the sonographic evaluation of diffuse thyroid disease So today we're going to talk about theuse thyroid disease and uh basically the division is between Graves disease and thyroiditis uh the vast majority of of thyroiditis is chronic lymphocytic thyroiditis but there are a number of other types of thyroiditis that that we were encounter as well now what are the sonographic findings of of of thyroiditis and autoimmune thyroid disease um in general we see gland enlargement the normal volumes uh scale by body habitus but roughly are listed for adults one of the things that I find useful is that often the ismos is enlarged the normal ismis is usually about 5 millimeters and that uh when it's larger than that I'm suspecting that there's underlying autoimmune thyroid disease but sometimes in fact you can have advanced autoimmune thyroid disease and your thyroid is normal