When a thyroid abnormality is palpable

Clinicians faced with a palpable thyroid abnormality should ascertain whether there is evidence of thyroid dysfunction, concern for malignancy, and symptoms of obstruction. In the vast majority of cases, laboratory assessment of the thyroid with an sTSH assay establishes the presence or absence of thyroid dysfunction. In a nodular thyroid gland, fine-needle aspiration biopsy is the method of choice for determining whether malignancy is present. In a large goiter, the presence of obstructive symptoms or findings may be a clear indication that surgery is needed. The absence of these findings may warrant simple observation.