Goiter screening

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S [2]

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 malignancy.

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:

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 are carried out in order to determine whether the goiter is affecting the production of thyroid hormone:
- Free thyroxine (T4)
- Thyroid stimulating hormone (TSH)

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 thyroid gland:
- Thyroid scan
- Ultrasound
- Biopsy of the thyroid 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.

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[pmid8565224-1] 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.

[pmid14571314-2] 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.

[pmid18142433-3] 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.

[pmid25996397-4] “Reorganized text”. JAMA Otolaryngol Head Neck Surg. 141 (5): 428. 2015. doi:10.1001/jamaoto.2015.0540. PMID 25996397.

[pmid19016002-5] 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.

[pmid2678263-6] 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.

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