Study note
Surgery
The thyroid gland
Clinical diagnosis of nodular goitre
THE CONTEXT
Nodular goitre usually
has a straightforward clinical presentation, although some findings can resemble carcinoma or autoimmune thyroiditis.
Typical presentation
•
The patient
is usually euthyroid. Thyroid nodules are palpable and often visible, with a smooth surface and usually firm rather than hard consistency.
•
The goitre
is painless and moves freely on swallowing.
Diagnostic difficulties
•
Calcification
can produce hardness and irregularity that simulate carcinoma.
•
A painful nodule, sudden appearance or rapid enlargement raises suspicion of carcinoma, but is usually due to haemorrhage into a simple nodule.
•
Distinguishing nodular goitre from autoimmune thyroiditis
may be difficult, and the two conditions frequently coexist.
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