The investigations for a patient with goitre are:

• thyroid antibodies (anti-peroxidase),

• ultrasound scan,

• isotope scan (essential in a thyrotoxic patient with a solitary thyroid nodule - differentiates a hot nodule in a normal gland from a cold nodule in a toxic gland),**

• computerised tomography (CT)/magnetic resonance imaging (MRI) scan (especially for suspected retrosternal gland),

• respiratory function tests (especially in a patient with stridor),

• fine-needle aspiration cytology (FNAC) (for a solitary nodule),**

• indirect laryngoscopy (especially for a re-do thyroidectomy, suspected malignancy or significant voice change).**

• = essential in all cases of goitre

** = essential pre-operative investigation

Figure 16.3. Thyroid pathology.
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