Pearls and Pitfalls in Pediatric Thyroid Imaging

Abstract

This article discusses the role of imaging of the thyroid gland in children, highlighting pearls and pitfalls. In the pediatric age group, thyroid imaging is mainly performed for the evaluation of congenital hypothyroidism, diffuse thyroid enlargement, and thyroid nodules. Permanent congenital hypothyroidism is most often caused by thyroid dysgenesis. Diffuse thyroid enlargement is mainly seen in teenage girls, and most often caused by Hashimoto disease, nodular hyperplasia, Graves disease, or diffuse papillary carcinoma. Thyroid nodules are less common in children than they are in adults, but more likely to be malignant; TI-RADS criteria may underestimate the risk of malignancy in children, and lead to erroneous classification downgrading. Knowledge of unique features of thyroid imaging in the pediatric population is critical for accurate diagnosis and management recommendations.