Hand Palpation Research Articles

Radiation and thyroid carcinoma: radiotherapy, head and neck regions, thyroid carcinoma.

Radiotherapy for benign conditions of the head and neck area was first linked to thyroid carcinoma in 1950. All the salivary glands, the parathyroids, and the facial skin can also develop neoplastic lesions in this setting. Thyroid carcinoma is most commonly papillary or mixed papillary and follicular. It is very often multifocal and can be detected by hand palpation, nuclear scanning, high resolution sonography, and needle aspiration. Each test has its limitations and appropriate protocols for screening and detection should be adapted to different medical centers. The surgical management is controversial and ranges from simple lobectomy to total thyroidectomy with adjuvant 131I treatment and thyroid suppression. We prefer total thyroidectomy if it can be performed safely. With adequate treatment the survival should be good. Prevention by administration of iodine at the time of exposure to radiation seems feasible and deserves further clinical trial.

Abdominal Palpation by Stethoscope

To the Editor .—Physical findings in a patient suspected of having an remain paramount in the assessment of the diagnosis. Every surgeon has seen a patient with minimal disturbance of temperature, pulse rate, white blood cell count, and with no abnormal roentgenographic findings, and who has localized tenderness that is proved to be due to acute appendicitis. It is sometimes difficult, especially in children and in emotionally disturbed patients, to be sure that the tenderness is real. For some considerable time, I have used a simple trick to elucidate whether the patient's pain is either real or exaggerated. It consists of palpating the abdomen a second time with the diaphragm of a stethoscope after clearly indicating to the patient that one is listening to the abdomen. This seems to distract the patient, for it is surprising how frequently the findings by hand palpation are not confirmed by pressing