How is goiter diagnosed?

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A multinodular goiter (MNG) is often first found on routine physical examination or when the patient seeks medical attention for a neck mass or increased size of the neck. As with all thyroid conditions, initial evaluation includes a detailed history, specifically focusing on hypo or hyperthyroid symptoms, family history of thyroid disease, history of head and neck irradiation, and factors suggestive of malignancy. These factors include any rapid growth of the neck mass, presence of associated enlarged neck lymph nodes, or new-onset hoarseness. Physical examination of a MNG is used to determine the size of goiter, the possible extension of the large thyroid under the breastbone (substernal extension), and signs of hyperfunction (rapid heart rate, irregular heart beats, tremors, etc.). Most patients have normal thyroid function with nontoxic MNG. Therefore laboratory examination is typically limited to TSH and free T4 levels.


Your doctor may be able to diagnose a goiter simply by feeling your neck during a physical examination. Several more tests can confirm a goiter. Blood tests can measure the level of thyroid hormones in your blood to test whether your thyroid is overactive or underactive. An ultrasound or thyroid scan can allow your doctor to see an image of your thyroid, and antibody tests can confirm whether an autoimmune disorder is causing your goiter.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.