Fever, redness, swelling Pain Blood tests of thyroid functions including TSH, T4 and T3 are usually normal [1] Ultrasonographic examination often shows the abscess or swelling in thyroid Gallium scan will be positive Barium swallow will show fistula connection to the piriform sinus and left lobe Elevated white blood cell count[3] Elevated erythrocyte sedimentation rate[3] Fine-needle aspiration