Department of Endocrine and Thyroid Surgery, Queen Alexandra Hospital, Portsmouth, UK.
Physical examination in thyroid diseases, should it be relied on?
M Sadri, C Y Yiangou, A. Dhanda
Department of thyroid surgery Queen Alexandra Hospital, Portsmouth
Objective: Assessment of the accuracy of physical examination performed by thyroid surgery team doctors at thyroid clinic.
Method: Random review of 120 new referrals to thyroid clinic, with review of clinical findings on physical examination on first attendance to clinic and compare the clinical findings with subsequent ultrasound scan findings.
Results: Of total number of 120 patients, 63 had solitary nodule on physical examination, 38 had normal examination of thyroid and 19 had diffuse goitre.
In the first group( solitary nodule) out of 63 patients, only 32 patients (50.7%) had solitary nodule in their ultrasound examination and the rest had other conditions ( Multinodular goitre 16 cases, diffuse goitre 2 cases, cyst 11 cases and 2 normal ultrasound examination).
In the second group (normal examination) out of 38 patients only 6 patients (15.7%)) had normal ultrasound examination and others had other conditions ( multinodular goitre 21 cases, solitary nodule 8 cases, cyst 2 cases and adenoma 1 case).
Finally in the third group (diffuse goitre) out of 19 cases only four patients (21%) had the same finding in ultrasound examination and the rest had other conditions (multinodular goitre 11 cases, solitary nodule 1 case and thyroiditis 3 cases).
Conclusion: Physical examination of thyroid gland on its own does not have any accuracy in assessment of thyroid gland diseases.
Suggestion: Para-clinical and imaging methods should be used in conjunction with physical examination.