Ultrasonography in Management of Nodular Thyroid Disease
Authors: Ellen Marqusee, P. Reed Larsen, Susan J. Mandel
Journal: Annals of Internal Medicine (2001)

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 ...References1. Brander A, Viikinkoski P, Tuuhea J, Voutilainen L, Kivisaari L. Clinical versus ultrasound examination of the thyroid gland in common clinical practice. J Clin Ultrasound. 1992;20:37-42. [PMID: 1309541] CrossrefMedlineGoogle Scholar2. Gharib H, Goellner JR. Fine-needle aspiration biopsy of the thyroid: an appraisal. Ann Intern Med. 1993;118:282-9. [PMID: 8420446] LinkGoogle Scholar3. Ortiz R, Hupart KH, DeFesi CR, Surks MI. Effect of early referral to an endocrinologist on efficiency and cost of evaluation and development of treatment plan in patients with thyroid nodules. J Clin Endocrinol Metab. 1998;83:3803-7. [PMID: 9814450] CrossrefMedlineGoogle Scholar4. Brkljacić B, Cuk V, Tomić-Brzac H, Bence-Zigman Z, Delić-Brkljacić D, Drinković I. Ultrasonic evaluation of benign and malignant nodules in echographically multinodular thyroids. J Clin Ultrasound. 1994;22:71-6. [PMID: 8132799] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Brigham and Women's Hospital; Boston, MA 02115 (Marqusee), (Larsen)University of Pennsylvania; Philadelphia, PA 19104 (Mandel) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUsefulness of Ultrasonography in the Management of Nodular Thyroid Disease Ellen Marqusee , Carol B. Benson , Mary C. Frates , Peter M. Doubilet , P. Reed Larsen , Edmund S. Cibas , and Susan J. Mandel Ultrasonography in Management of Nodular Thyroid Disease Matthew C. Leinung , Andrew Gianoukakis , and Daniel W. Lee Ultrasonography in Management of Nodular Thyroid Disease Jorge L. Gross Metrics 4 September 2001Volume 135, Issue 5Page: 384KeywordsPatientsSpecificitySurgeryThyroidThyroid carcinomaThyroid diseasesThyroid-stimulating hormoneUltrasound imaging ePublished: 4 September 2001 Issue Published: 4 September 2001 CopyrightCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...