Ultrasonic Diagnosis of Graves' Ophthalmopathy

Precise and reproducible ultrasonographic measurements of the extraocular muscles, particularly the medial, lateral and superior and interior recti, has greatly improved the diagnosis of Graves' ophthalmopathy. Properly performed standardized echography (SE) is unequivocally the most effective method of demonstrating the size and structural characteristics of the extraocular muscles and optic nerves. Being able to quantitate eye muscle size and its acoustic characteristics, i.e., heterogeneity and reflectivity, allows the experienced examiner to make a specific diagnosis of Graves' ophthalmopathy without subjecting a patient to the risks, discomfort, expense, and often equivocal results of CT or MRI scanning. This presentation will illustrate the acoustic hallmarks of Graves' ophthalmopathy and will prove that SE is today's most sensitive and specific test for Graves' ophthalmopathy, whether the patient is hyperthyroid, hypothyroid, or as is most frequently the case, euthyroid.