Symptoms of soreness and pain in a particular part of the throat are a common complaint that doctors come across often. However, lack of any other specific symptoms can make the diagnosis and treatment of this complaint particularly difficult.
There are a number of things in close anatomical proximity that could be causing these symptoms:
- Inflammation of a lymph node
- A deep lying cyst
- Inflammation of the thyroid gland
- Aberrant thyroid tissue
- A tumor
The most common cause among those listed above is an inflamed lymph node. Smaller, deeper lying, lymph nodes can be harder to locate and even palpate although they continue to be inflamed and painful.
These lymph nodes can be inflamed because of a chronic infection in the nearby areas. A common cause could be an infected tooth, infection of the tonsils or other areas of the oral cavity.
These symptoms would be accompanied by others such as pain, swelling and discomfort in the area of origin.
Sometimes an infection can be contained in the deeper part of the throat, without disappearing completely. In such cases a cyst can be formed. These are fluid-filled structures that develop as a result of the process of necrosis and destruction of the nearby structures.
A cyst can be painless or painful depending upon the overlying inflammation and phase of activity of the infection.
Inflammation of the thyroid gland is always a possibility, particularly when a non-specific infection in the region of the neck is present. Thyroiditis can be inflammation of the main gland itself or the isthmus which runs in close relation to the main muscle of the neck, the sternocleidomastoid.
The main culprit of this inflammation is viral or bacterial infection. Sometimes a drug allergy can also cause an inflammation of the thyroid. This is usually self-limiting with only palliative treatment being required.
The other possible causes are less common, but should not be ruled out without proper investigation. The presence of aberrant thyroid tissue can be confirmed by thyroid function tests or a radioactive iodine uptake scan.
The presence of a tumor can be confirmed by a biopsy as well as further investigations to ensure that other parts of the body do not have similar growths.
Investigations and treatment
A high-frequency ultrasound to confirm the presence of a cyst or a deep lying lymph node should be carried out. The initial finding will be confirmed by a CT scan of the neck.
A blood test with raised ESR would be a non-specific pointer towards thyroid inflammation. A tumor would need a fine needle aspiration cytology (FNAC) test to be done to conclusively confirm or rule out any metastatic growth.
The treatment for a cyst is to aspirate its contents and let it collapse while thyroiditis is self limiting in nature with only anti inflammatory drugs needed. A confirmation of a tumor would need prolonged treatment depending upon the kind of tumor it is confirmed to be.
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