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Old 08-28-2012
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Default Solitary thyroid nodule

Hi,
Just to clear up how to manage the finding of a solitary thyroid nodule on PE.

1. Measure TSH
2. If TSH is low, proceed to radionucleotide scan.
3. If radionucleotide scan has decreased uptake (cold/hypofunctioning), proceed to US.
If radionucleotide scan has increased uptake (hyperfunctioning) workup for hyperthyroid state.
4. If suspicion of malignancy on US, do FNA

1. If TSH is measured as high proceed to US
2. If suspicion of malignancy on US, proceed to FNA

Also, there are reasons to suspect malignancy: cervical lymphadenopathy, obstructive symptoms (dysphagia), vocal cord paralysis and a fixed hard nodule. Do these considerations (especially the fixed hard nodule that does not move with swallowing) change our steps of management?

Please let me know if I have misunderstood something, this is supposed to be very high yield for the exam, thanks!
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Old 08-28-2012
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If you have a high index of suspicion of malignancy clinically then you go directly for surgery.

There was a discussion about it here
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The above post was thanked by:
mis.med88 (08-29-2012)
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Old 08-29-2012
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Default Solitary nodule

In the work up of solitary nodule,not only TSH,but T 4,is also required,so that we may assess the status of thyroid gland,becz there is no immediate need of biopsy if hyper functioning gland,,
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Old 08-29-2012
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Quote:
Originally Posted by salman View Post
In the work up of solitary nodule,not only TSH,but T 4,is also required,so that we may assess the status of thyroid gland,becz there is no immediate need of biopsy if hyper functioning gland,,
and what does TSH levels tell you?
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Old 08-30-2012
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TSH and t4'both will help to find the status and site of problem,is anything wrong with it?i will be great full if u will tell something more productive
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