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Thyroid Investigations

  • Victoria J. Stokes
  • Rabia Arfan
  • Theingi Aung
  • Violet Fazal-SandersonEmail author
Chapter

Abstract

Thyroid dysfunction may result in inappropriate hormone secretion, mass effects, or a combination of both problems. Taking a relevant history and performing a thorough examination is the first step to reaching the correct diagnosis. Investigations should be selected according to the clinical findings and may be used to confirm clinical suspicions, to rule out serious pathology, and to establish the severity of the dysfunction. Blood tests are usually the first line, with biochemistry to confirm the functional status of the gland and, if appropriate, testing for autoantibodies to confirm autoimmunity. Ultrasound is the preferred method for detecting intra-thyroid lesions, with a sensitivity of 2 mm for cystic, and 3 mm for solid lesions. CT and MRI are of limited utility outside of tumour staging. Functional imaging is useful for differentiating thyroiditis and hyperthyroidism due to autoimmunity, toxic nodule, or multinodular goitre. This chapter describes the clinical features of different thyroid disorders; discusses thyroid investigations and their clinical utility; and highlights specific tests used for specific disorders.

Keywords

Thyroid hormone homeostasis Imaging Clinical assessment Thyroid autoantibodies TSH-oma 

Abbreviations

bHCG

Beta human chorionic gonadotropin

CT

Computer tomography

FNA/C

Fine needle aspiration/cytology

fT3

Triiodothyronine

fT4

Thyroxine

MRI

Magnetic resonance imaging

RTSH

Resistance to thyroid stimulating hormone

TG Ab

Antithyroglobulin antibody

TIRADS

Thyroid imaging reporting and data system

TPOAbs

Antithyroid peroxidase antibody

TSH

Thyroid stimulating hormone

TSHoma

Thyroid stimulating hormone secreting pituitary adenoma

TSH receptor antibody

Thyroid stimulating hormone receptor antibody

US

Ultrasound

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Victoria J. Stokes
    • 1
  • Rabia Arfan
    • 2
  • Theingi Aung
    • 3
  • Violet Fazal-Sanderson
    • 3
    Email author
  1. 1.Endocrinology and MetabolismOxford Radcliffe Hospitals NHS Foundation Trust, Churchill HospitalOxfordUK
  2. 2.Thames Valley Deanary, Centre for Diabetes and Endocrinology, Royal Berkshire Hospital NHS Foundation TrustReadingUK
  3. 3.Centre for Diabetes and Endocrinology, Royal Berkshire Hospital NHS Foundation TrustReadingUK

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