Methodological limitations of an etiological framing of Ariarathes' goitre: Response to Tekiner et al.

In a recent article published in this journal, Tekiner et al. [1] presented a most interesting example of retrospective diagnosis based on the recognition of a pathological trait in artistic representations. King Ariarathes IV Eusebes of Cappadocia is diagnosed with goitre using a coin minted in the 33rd year of his reign on whose obverse the king’s neck shows a dramatically enlarged anterior compartment. While the proposed diagnosis is undoubtedly correct and highly suggestive of thyroid pathology, we would like to point out that a stylized representation of the king’s traits may not be enough to venture into the field of aetiology.