Assessment of Thyroid Problems
History and Examination
To assess the activity of the thyroid gland, the surgeon will take a medical history and perform a physical examination. Particular attention will be paid to the thyroid gland in the neck.
Blood Tests
Blood will be taken for thyroid function tests (TFTs); TFTs measure the activity of the gland, through the production of Thyroid Stimulating Hormone (TSH), T4 and, if required, the T3.
Blood will also be checked to make sure that the body has not produced any antibodies to the thyroid (auto-immune disease).
Ultrasound
Ultrasound scans can assess the thyroid gland for its overall size as well as the presence of any lumps. Ultrasound can also be used to help obtain a needle sample (cytology) from a small lump that is difficult to feel.
Cytology
All thyroid lumps will have a needle sample taken; this may also be undertaken when the thyroid is enlarged. A fine needle is inserted into the gland and a cell sample obtained that can be examined under a microscope.
Radionuclide Scans
This scan involves injecting a tiny amount of radioactive material. This material is taken up by the thyroid gland and the radioactivity can be measured to give a picture of how well the gland is working. The test is absolutely harmless and may show areas of the thyroid that are under-active or over-active. Together with the ultrasound scan, this test helps to establish the correct treatment.
Other Tests
Occasionally other tests will be needed. A chest x-ray can sometimes show if a large gland is affecting the windpipe and a CT or MRI scan can help to show more exactly the extent of any thyroid swelling.