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Thyroid Investigations

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Advanced Practice in Endocrinology Nursing

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Abstract

Thyroid dysfunction may result in inappropriate hormone secretion, mass effects, or a combination of both problems. Taking a relevant history and performing a thorough examination is the first step to reaching the correct diagnosis. Investigations should be selected according to the clinical findings and may be used to confirm clinical suspicions, to rule out serious pathology, and to establish the severity of the dysfunction. Blood tests are usually the first line, with biochemistry to confirm the functional status of the gland and, if appropriate, testing for autoantibodies to confirm autoimmunity. Ultrasound is the preferred method for detecting intra-thyroid lesions, with a sensitivity of 2 mm for cystic, and 3 mm for solid lesions. CT and MRI are of limited utility outside of tumour staging. Functional imaging is useful for differentiating thyroiditis and hyperthyroidism due to autoimmunity, toxic nodule, or multinodular goitre. This chapter describes the clinical features of different thyroid disorders; discusses thyroid investigations and their clinical utility; and highlights specific tests used for specific disorders.

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Abbreviations

bHCG:

Beta human chorionic gonadotropin

CT:

Computer tomography

FNA/C:

Fine needle aspiration/cytology

fT3:

Triiodothyronine

fT4:

Thyroxine

MRI:

Magnetic resonance imaging

RTSH:

Resistance to thyroid stimulating hormone

TG Ab:

Antithyroglobulin antibody

TIRADS:

Thyroid imaging reporting and data system

TPOAbs:

Antithyroid peroxidase antibody

TSH:

Thyroid stimulating hormone

TSHoma:

Thyroid stimulating hormone secreting pituitary adenoma

TSH receptor antibody:

Thyroid stimulating hormone receptor antibody

US:

Ultrasound

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Author information

Authors and Affiliations

  1. Endocrinology and Metabolism, Oxford Radcliffe Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, UK

    Victoria J. Stokes

  2. Thames Valley Deanary, Centre for Diabetes and Endocrinology, Royal Berkshire Hospital NHS Foundation Trust, Reading, UK

    Rabia Arfan

  3. Centre for Diabetes and Endocrinology, Royal Berkshire Hospital NHS Foundation Trust, Reading, UK

    Theingi Aung & Violet Fazal-Sanderson

Authors
  1. Victoria J. Stokes
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  2. Rabia Arfan
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  3. Theingi Aung
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  4. Violet Fazal-Sanderson
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Corresponding author

Correspondence to Violet Fazal-Sanderson .

Editor information

Editors and Affiliations

  1. School of Health Sciences, City, University of London, London, UK

    Sofia Llahana

  2. Department of Oncology, Skåne University Hospital, Lund, Sweden

    Cecilia Follin

  3. Northwest Pituitary Center Oregon Health and Sciences University, Portland, OR, USA

    Christine Yedinak

  4. Churchill Hospital, University of Oxford, Oxford, UK

    Ashley Grossman

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Stokes, V.J., Arfan, R., Aung, T., Fazal-Sanderson, V. (2019). Thyroid Investigations. In: Llahana, S., Follin, C., Yedinak, C., Grossman, A. (eds) Advanced Practice in Endocrinology Nursing. Springer, Cham. https://doi.org/10.1007/978-3-319-99817-6_27

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  • DOI: https://doi.org/10.1007/978-3-319-99817-6_27

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-99815-2

  • Online ISBN: 978-3-319-99817-6

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