Initial evaluation of a patient with a thyroid nodule

TSH: thyroid-stimulating hormone; FT4: free thyroxine; T3: triiodothyronine; FNA: fine-needle aspiration.
* Patients with TSH above the normal range require an evaluation for hypothyroidism. Refer to UpToDate content on hypothyroidism.
¶ Patients with TSH below the normal range require an evaluation for hyperthyroidism. Refer to UpToDate content on hyperthyroidism.
Δ Thyroid nodules that do not meet sonographic criteria for FNA should be monitored with periodic ultrasonography. The frequency of evaluation (ranging from 6 to 24 months) depends upon the sonographic features of the nodules.
◊ Selected cases of subclinical hyperthyroidism warrant treatment. Refer to UpToDate content on subclinical hyperthyroidism and toxic adenoma.