The patient is a 26-year-old female with a past medical history significant for IV drug use and a right-sided multinodular goiter who presented with five days of anterior neck swelling, predominantly on the right side, and associated tenderness to palpation. In the week prior to presentation, the patient had developed a sore throat, fatigue, and rhinorrhea, along with an abscess on the posterior aspect of her left forearm where she injects heroin. She denied ever injecting drugs into her neck or shoulders. Her review of systems was negative for fevers, chills, rigors, shortness of breath, wheezing, difficulty breathing, dysphagia, and chest pain. She further denied weakness, muscle twitching, diarrhea, constipation, weight loss, weight gain, and palpitations. Her multinodular goiter had been discovered about one year prior. At the time, she was asymptomatic and thyroid function tests were within normal limits, but no fine-needle aspiration (FNA) biopsy was performed.