What should you know?
Thyroid nodules are very common and most are benign. Ultrasound is used not merely to find a nodule but to describe its structure and stratify imaging risk in a standardized way.
Ultrasound may be requested for a palpable lump, neck pressure, an abnormal examination, suspicious lymph nodes or an incidental nodule. Thyroid function is assessed with blood tests, not ultrasound.
Common symptoms and signs
- A visible or palpable neck lump
- Pressure or difficulty swallowing
- Persistent new hoarseness
- No symptoms in many patients
Diagnosis and the role of ultrasound
Ultrasound evaluates composition, echogenicity, shape, margins and echogenic foci. The ACR TI-RADS category together with nodule size guides whether observation or fine-needle aspiration should be considered.
- Three-dimensional measurement
- Solid, cystic or mixed composition
- Margins, shape and echogenic foci
- Cervical lymph nodes
Treatment and next steps
Many small low-risk nodules need no biopsy and sometimes no follow-up. Biopsy is considered when morphology and size meet guideline thresholds and clinical risk is integrated.
When is urgent care needed?
- Rapidly worsening breathing or swallowing
- Fast-growing neck swelling
- A nodule with persistent hoarseness or abnormal lymph nodes