▁reve al ▁un il ob ular ▁sw elling . ▁ ▁Depending ▁on ▁the ▁age ▁and ▁imm une ▁status ▁of ▁the ▁patient ▁more ▁invas ive ▁procedures ▁may ▁be ▁performed ▁such ▁as ▁fine ▁need le ▁asp iration ▁of ▁the ▁neck ▁mass ▁to ▁facil itate ▁a ▁diagn osis . ▁ ▁In ▁cases ▁where ▁the ▁in fection ▁is ▁thought ▁to ▁be ▁associated ▁with ▁a ▁sin us ▁f ist ula ▁it ▁is ▁often ▁necessary ▁to ▁confirm ▁the ▁presence ▁of ▁the ▁f ist ula ▁through ▁surg ery ▁or ▁l ary ng os cop ic ▁exam ination . ▁ ▁While ▁invas ive ▁procedures ▁can ▁often ▁tell ▁definit ively ▁whether ▁or ▁not ▁a ▁f ist ula ▁is ▁present , ▁new ▁studies ▁are ▁working ▁on ▁the ▁use ▁of ▁computed ▁tom ography ▁as ▁a ▁useful ▁method ▁to ▁visual ize ▁and ▁detect ▁the ▁presence ▁of ▁a ▁sin us ▁f ist ula . ▁ ▁Di agnostic ▁tests ▁ ▁F ever , ▁red ness , ▁sw elling ▁P ain ▁Blood ▁tests ▁of ▁thy roid ▁functions ▁including ▁T SH , ▁T 4 ▁and ▁T 3 ▁are ▁usually ▁normal ▁ ▁Ul tr ason ographic ▁exam ination ▁often ▁shows ▁the ▁abs cess ▁or ▁sw elling ▁in ▁thy roid ▁ ▁Gal li um ▁scan ▁will ▁be ▁positive ▁B arium ▁sw allow ▁will ▁show ▁f ist ula ▁connection ▁to ▁the ▁pir iform ▁sin us ▁and ▁left ▁lo be ▁E lev ated ▁white ▁blood ▁cell ▁count ▁E lev ated ▁er yth ro cy te ▁sed iment ation ▁rate ▁Fine - need le ▁asp iration ▁ ▁Sub types ▁of ▁thy roid itis ▁