Thyroid nodule physical examination

Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing.

Thyroid nodule Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Thyroid nodule from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic study of choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Thyroid nodule physical examination On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Thyroid nodule physical examination All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Thyroid nodule physical examination
CDC on Thyroid nodule physical examination
Thyroid nodule physical examination in the news
Blogs on Thyroid nodule physical examination
Directions to Hospitals Treating Thyroid nodule
Risk calculators and risk factors for Thyroid nodule physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Physical examination should focus on the thyroid gland and the lateral and central neck and should assess for supraclavicular and submandibular adenopathy.

Physical Examination

a rapid pulse rate may suggest hyperthyroidism, and hypertension may occur in the context of multiple endocrine neoplasia, type II (MEN II)

HEENT

• Thyroid nodule
  • Solitary or dominant in a multinodular goiter
  • Characteristics of the nodule, including:
    • Size
    • Consistency (e.g., soft, firm, woody, or hard)
      • Nodules that are firm or immobile are more likely to harbor cancer than those that are soft or mobile
      • Large, firm cervical nodes ipsilateral to the thyroid nodule should suggest the possibility of local metastases from thyroid cancer
      • firm to hard, irregular, fixed, nontender nodule is more likely to be a thyroid malignant neoplasm
      • A smooth, soft, easily mobile nodule suggests benignancy, as does the presence of tenderness
      • some benign nodules can be very hard because of calcifications
      • Multinodularity, especially if the nodules all have the same con¬ sistency, is consistent with a be¬ nign multinodular goiter. A nodule or mass that is dominant in size or has a different consistency than other nodules within the gland should be evaluated for malignancy more precisely
      • A midline nodule over the hyoid bone that moves up with protrusion of the tongue is likely to be a thyroglossal duct cyst.
    • Involvement with adjacent structures
• Cervical lymph nodes, including:
  • submental and submandibular nodes
  • upper jugular nodes
  • midjugular nodes
  • lower jugular nodes
  • posterior triangle and supraclavicular nodes
  • pretracheal, prelaryngeal, and paratracheal nodes
• Deviation of the trachea, which suggests a mass