Abstract
In this review we discuss the significance of the main ultrasonographic features of common thyroid and parathyroid conditions, with a focus on the advantages of real time observation. The thyroid specialist, defined as an endocrinologist with a major interest in thyroid disorders and access to a portable ultrasound machine, can correlate what they see with the thyroid blood test results and clinical findings in a way that is not available to the general endocrinologist who relies on the interpretation by the consultant radiologist of ultrasound images prepared by a technician. We also discuss the significance of the small, very bright, intra nodular microcalcifications found in benign colloid nodules, which we call “colloid spots” and the difference between these and the 3–4 mm soft microcalcifications that are 90% specific for papillary thyroid cancer and provide a new system for staging the inflammatory changes in Hashimoto thyroiditis, as observed on ultrasonography.
Highlights
Thyroid ultrasonography has become a routine tool for the endocrinologist in the diagnosis and management of thyroid and parathyroid disorders [1,2]
It is clear that the thyroid specialist (“thyroidologist”) with a portable ultrasound machine is in the best position to correlate the features of thyroid nodules and other thyroid disorders with the clinical findings and blood test results
In this review we describe the ultrasound features of the common types of thyroid disorders, how to correctly interpret what is seen, when to repeat the imaging and when to carry out fine needle aspiration biopsies (FNAB) of suspicious nodules
Summary
Thyroid ultrasonography has become a routine tool for the endocrinologist in the diagnosis and management of thyroid and parathyroid disorders [1,2]. It is clear that the thyroid specialist (“thyroidologist”) with a portable ultrasound machine is in the best position to correlate the features of thyroid nodules and other thyroid disorders with the clinical findings and blood test results. The thyroid specialist can provide “one stop shopping” for their patients as they perform their own fine needle aspiration biopsies (FNAB) of suspicious nodules. In this review we describe the ultrasound features of the common types of thyroid disorders, how to correctly interpret what is seen, when to repeat the imaging and when to carry out FNAB of suspicious nodules. The purpose of the review is to provide an understanding of the utility of real time thyroid, parathyroid and neck ultrasound for the aspiring thyroid specialist, its scope in the office and how can it help in the patient’s management.
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