Thyroid nodule physical examination

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Thyroid nodule Microchapters
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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

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
    • 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