Letters4 September 2001Ultrasonography in Management of Nodular Thyroid DiseaseEllen Marqusee, MD, P. Reed Larsen, MD, FRCP, and Susan J. Mandel, MD, MPHEllen Marqusee, MDBrigham and Women's Hospital; Boston, MA 02115 (Marqusee), (Larsen)University of Pennsylvania; Philadelphia, PA 19104 (Mandel)Search for more papers by this author, P. Reed Larsen, MD, FRCPBrigham and Women's Hospital; Boston, MA 02115 (Marqusee), (Larsen)University of Pennsylvania; Philadelphia, PA 19104 (Mandel)Search for more papers by this author, and Susan J. Mandel, MD, MPHBrigham and Women's Hospital; Boston, MA 02115 (Marqusee), (Larsen)University of Pennsylvania; Philadelphia, PA 19104 (Mandel)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-5-200109040-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Leinung and colleagues that thyroid ultrasonography detects many nodules not palpated on physical examination. However, we disagree that the routine use of thyroid ultrasonography in patients with suspected nodular thyroid disease leads to unnecessary ultrasonography and surgeries.We aspirated nodules that were 1 cm or larger. Previous studies have demonstrated that on physical examination, experienced clinicians often miss nodules that are larger than 1 cm on ultrasonography (1). There is no logic to the contention that a nonpalpable nodule larger than 1 cm is less likely to be malignant than a palpable 1-cm nodule. Our ...