Hello!
If you find a thyroid nodule on clinical examination, the next best step is to get a TSH level.
Why? Because it helps you decide which investigation to order next!
If TSH is low, you need to do a radionucleotide scan first.
Why? Because it helps you decide whether or not you need a fine needle aspiration cytology (FNAC)
If the nodule is functioning, do not do a FNA. It just means hyperthyroidism. Observe or treat depending of FT4, T3 levels.
If the nodule is non functional, however, you must do a FNAC for a possible malignancy.
If TSH is normal or elevated, it means there could be something suspicious in the glad, do FNAC of the nodule.
Why not do a scan? Because the nodule will likely be non functional and will tell you nothing else to change your management,
UpToDate mentions sonographic criteria for biopsy before jumping to a FNA, but Master The Boards says that USG can never exclude malignancy and you must always do a FNAC.
If you find a thyroid nodule on clinical examination, the next best step is to get a TSH level.
Why? Because it helps you decide which investigation to order next!
If TSH is low, you need to do a radionucleotide scan first.
Why? Because it helps you decide whether or not you need a fine needle aspiration cytology (FNAC)
If the nodule is functioning, do not do a FNA. It just means hyperthyroidism. Observe or treat depending of FT4, T3 levels.
If the nodule is non functional, however, you must do a FNAC for a possible malignancy.
If TSH is normal or elevated, it means there could be something suspicious in the glad, do FNAC of the nodule.
Why not do a scan? Because the nodule will likely be non functional and will tell you nothing else to change your management,
UpToDate mentions sonographic criteria for biopsy before jumping to a FNA, but Master The Boards says that USG can never exclude malignancy and you must always do a FNAC.
 |
| Investigating thyroid nodule |
That's all!
-IkaN
Great article with excellent idea!Many thanks for this kind of valuable article. I really appreciate because of this great information.. There are so many types of diseases nowadays which are creating health issues which are mostly undiscoverable. for example Fluoroquinolones, Fluoroquinolones are a class of antibiotics approved to treat or prevent certain bacterial infections. we are finding the treatments of it here floxed treatment
ReplyDelete