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Conditions/Thyroid Disease/Chapter

Detailed chapter

Thyroid Disease — Thyroid Diagnosis

Exam, blood tests, ultrasound, and FNA

Evaluation starts with neck exam, thyroid function tests (TSH ± free T4/T3), high-resolution ultrasound, and fine-needle aspiration (FNA) for suspicious nodules. Preoperative voice assessment matters when symptoms or reoperation are present. CT, MR, or scintigraphy may be added.

Diagnosis · stepwise workup · English labels below

Key points

  • Blood tests
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    TSH first; low TSH may trigger scintigraphy; high TSH prompts free T4 and autoimmunity workup. Calcitonin/CEA if medullary cancer is suspected.

  • Ultrasound
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    Characterizes solid/cystic pattern, margins, calcifications, and nodes. Risk stratification (e.g., TI-RADS) sets biopsy thresholds.

  • Fine-needle aspiration
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    Ultrasound-guided FNA with Bethesda classification guides next steps. Indeterminate results are not automatic cancer.

  • Voice assessment
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    Laryngoscopy before surgery when hoarseness, prior neck surgery, or large/invasive disease is present.

This page is for education. It is not medical advice and does not replace a visit with your physician.

Medical editor: Assoc. Prof. Cengiz Dibekoğlu, MD · Last medically reviewed: August 2026 · English patient-education chapter.