Goiter screening: Difference between revisions
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{{CMG}}; {{AE}} | {{CMG}}; {{AE}} | ||
==Overview== | ==Overview== | ||
Screening for | Screening for goiter initially involves physical examination followed by blood tests for free [[T4]] and [[TSH]] and finally thyroid scan, [[ultrasound]] and [[biopsy]] to rule out malignanacy. | ||
==Screening== | ==Screening== | ||
Screening for goiter includes the following approaches and progresses to the next approach based on the result of earlier screening procedure: <ref name="pmid8565224">{{cite journal |vauthors=Ladenson PW |title=Optimal laboratory testing for diagnosis and monitoring of thyroid nodules, goiter, and thyroid cancer |journal=Clin. Chem. |volume=42 |issue=1 |pages=183–7 |year=1996 |pmid=8565224 |doi= |url=}}</ref><ref name="pmid14571314">{{cite journal |vauthors=Dietlein M, Moka D, Schmidt M, Theissen P, Schicha H |title=[Prevention, screening and therapy of thyroid diseases and their cost-effectiveness] |language=German |journal=Nuklearmedizin |volume=42 |issue=5 |pages=181–9 |year=2003 |pmid=14571314 |doi= |url=}}</ref><ref name="pmid18142433">{{cite journal| author=COLE WH, MAJARAKIS JD, SLAUGHTER DP| title=Incidence of carcinoma of the thyroid in nodular goiter. | journal=J Clin Endocrinol Metab | year= 1949 | volume= 9 | issue= 10 | pages= 1007-11 | pmid=18142433 | doi=10.1210/jcem-9-10-1007 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18142433 }} </ref><ref name="pmid25996397">{{cite journal| author=| title=Reorganized text. | journal=JAMA Otolaryngol Head Neck Surg | year= 2015 | volume= 141 | issue= 5 | pages= 428 | pmid=25996397 | doi=10.1001/jamaoto.2015.0540 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25996397 }} </ref><ref name="pmid19016002">{{cite journal |vauthors=Gursoy A, Anil C, Unal AD, Demirer AN, Tutuncu NB, Erdogan MF |title=Clinical and epidemiological characteristics of thyroid hemiagenesis: ultrasound screening in patients with thyroid disease and normal population |journal=Endocrine |volume=33 |issue=3 |pages=338–41 |year=2008 |pmid=19016002 |doi=10.1007/s12020-008-9095-5 |url=}}</ref><ref name="pmid2678263">{{cite journal| author=Brander A, Viikinkoski P, Nickels J, Kivisaari L| title=Thyroid gland: US screening in middle-aged women with no previous thyroid disease. | journal=Radiology | year= 1989 | volume= 173 | issue= 2 | pages= 507-10 | pmid=2678263 | doi=10.1148/radiology.173.2.2678263 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2678263 }} </ref> | |||
**'''Physical exam:''' | **'''Physical exam:''' | ||
***Involves the assessment of the size and the extent of enlargement of the thyroid gland. If the | ***Involves the assessment of the size and the extent of enlargement of the thyroid gland. If the gland is enlarged, blood tests for [[free T4]] and [[TSH]] are evaluated. | ||
**'''Blood Tests:''' | **'''Blood Tests:''' | ||
***Blood tests are carried out in order to determine whether the | ***Blood tests are carried out in order to determine whether the goiter is affecting the production of [[thyroid hormone]]. | ||
****[[Free | ****[[Thyroxine|Free thyroxine]] ([[T4]]) | ||
****[[Thyroid stimulating hormone]] ([[TSH]]) | ****[[Thyroid stimulating hormone]] ([[TSH]]) | ||
**'''Further evaluation to rule out [[malignancy]]:''' | **'''Further evaluation to rule out [[malignancy]]:''' | ||
***Based on the results of the physical exam and blood tests, further evaluation involving the following is advised in order to rule out malignant transformation of the gland: | ***Based on the results of the physical exam and blood tests, further evaluation involving the following is advised in order to rule out malignant transformation of the gland: | ||
**** | ****Thyroid scan | ||
****[[Ultrasound]] | ****[[Ultrasound]] | ||
****[[Biopsy]] of the gland | ****[[Biopsy]] of the gland |
Revision as of 20:28, 20 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Screening for goiter initially involves physical examination followed by blood tests for free T4 and TSH and finally thyroid scan, ultrasound and biopsy to rule out malignanacy.
Screening
Screening for goiter includes the following approaches and progresses to the next approach based on the result of earlier screening procedure: [1][2][3][4][5][6]
- Physical exam:
- Blood Tests:
- Blood tests are carried out in order to determine whether the goiter is affecting the production of thyroid hormone.
- Further evaluation to rule out malignancy:
- Based on the results of the physical exam and blood tests, further evaluation involving the following is advised in order to rule out malignant transformation of the gland:
- Thyroid scan
- Ultrasound
- Biopsy of the gland
- Based on the results of the physical exam and blood tests, further evaluation involving the following is advised in order to rule out malignant transformation of the gland:
References
- ↑ Ladenson PW (1996). "Optimal laboratory testing for diagnosis and monitoring of thyroid nodules, goiter, and thyroid cancer". Clin. Chem. 42 (1): 183–7. PMID 8565224.
- ↑ Dietlein M, Moka D, Schmidt M, Theissen P, Schicha H (2003). "[Prevention, screening and therapy of thyroid diseases and their cost-effectiveness]". Nuklearmedizin (in German). 42 (5): 181–9. PMID 14571314.
- ↑ COLE WH, MAJARAKIS JD, SLAUGHTER DP (1949). "Incidence of carcinoma of the thyroid in nodular goiter". J Clin Endocrinol Metab. 9 (10): 1007–11. doi:10.1210/jcem-9-10-1007. PMID 18142433.
- ↑ "Reorganized text". JAMA Otolaryngol Head Neck Surg. 141 (5): 428. 2015. doi:10.1001/jamaoto.2015.0540. PMID 25996397.
- ↑ Gursoy A, Anil C, Unal AD, Demirer AN, Tutuncu NB, Erdogan MF (2008). "Clinical and epidemiological characteristics of thyroid hemiagenesis: ultrasound screening in patients with thyroid disease and normal population". Endocrine. 33 (3): 338–41. doi:10.1007/s12020-008-9095-5. PMID 19016002.
- ↑ Brander A, Viikinkoski P, Nickels J, Kivisaari L (1989). "Thyroid gland: US screening in middle-aged women with no previous thyroid disease". Radiology. 173 (2): 507–10. doi:10.1148/radiology.173.2.2678263. PMID 2678263.