Thyroid nodule physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Physical examination should focus on the thyroid gland and the lateral and central neck and should assess for supraclavicular and submandibular adenopathy. The most important finding in physical examination that need a more attention include assessing the nodule's size and consistency, localized tenderness in the nodular area, lymphadenopathy, and physical exams coordinated with hypo- or hyperthyroidism.

Physical Examination

Physical examination of patients with thyroid nodule is usually remarkable for:[1][2][3][4]

Appearance of the patient


Differentiated thyroid carcinoma (particularly papillary carcinoma) involves cervical lymph nodes in 20–50% of patients in most series using standard histopathological techniques, and may be present even when the primary tumor is small and intrathyroidal.[5]

The frequency of micrometastases may approach 90%.[6]



  1. Bomeli SR, LeBeau SO, Ferris RL (2010). "Evaluation of a thyroid nodule". Otolaryngol. Clin. North Am. 43 (2): 229–38, vii. doi:10.1016/j.otc.2010.01.002. PMC 2879398. PMID 20510711.
  2. Lawrence W, Kaplan BJ (2002). "Diagnosis and management of patients with thyroid nodules". J Surg Oncol. 80 (3): 157–70. doi:10.1002/jso.10115. PMID 12115799.
  3. Popoveniuc G, Jonklaas J (2012). "Thyroid nodules". Med. Clin. North Am. 96 (2): 329–49. doi:10.1016/j.mcna.2012.02.002. PMC 3575959. PMID 22443979.
  4. Milas Z, Shin J, Milas M (2011). "New guidelines for the management of thyroid nodules and differentiated thyroid cancer". Minerva Endocrinol. 36 (1): 53–70. PMID 21460787.
  5. Hay ID, Grant CS, van Heerden JA, Goellner JR, Ebersold JR, Bergstralh EJ (1992). "Papillary thyroid microcarcinoma: a study of 535 cases observed in a 50-year period". Surgery. 112 (6): 1139–46, discussion 1146–7. PMID 1455316.
  6. Chang YW, Kim HS, Jung SP, Kim HY, Lee JB, Bae JW, Son GS (2017). "Significance of micrometastases in the calculation of the lymph node ratio for papillary thyroid cancer". Ann Surg Treat Res. 92 (3): 117–122. doi:10.4174/astr.2017.92.3.117. PMC 5344800. PMID 28289664.

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