Jorge L. Gross, MD
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Gross JL. Ultrasonography in Management of Nodular Thyroid Disease. Ann Intern Med. 2001;135:383-384. doi: 10.7326/0003-4819-135-5-200109040-00024
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Published: Ann Intern Med. 2001;135(5):383-384.
TO THE EDITOR:
Growing evidence suggests that ultrasonography is as useful for the endocrinologist as the stethoscope is for the cardiologist. In an elegant and well-conducted study, Marqusee and colleagues (1) reported that ultrasonography altered the clinical management for 63% of the patients studied. This indicates that ultrasonography is useful in addition to physical examination in the evaluation of patients with suspected thyroid nodules. Lisbôa and coworkers (2) also previously observed that clinical examination is not an accurate method to establish the presence of goiter in schoolchildren; it tends to overestimate thyroid size, and ultrasonography should be performed when the thyroid is thought to be enlarged. Also, ultrasonography could provide useful information regarding the diagnosis of malignancy in thyroid nodules. For example, it could detect the presence of microcalcifications in solid hypoechoic nodules with poorly defined margins, which increases the risk for malignancy (3). This information could be valuable in the therapeutic decision-making process, especially when the cytopathologic results of fine-needle aspiration are nondiagnostic, atypical, or suspicious. Therefore, it would be interesting if Marqusee and colleagues could also analyze the accuracy of ultrasonography for assessing these additional ultrasonographic applications in their sample of patients who had surgery.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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