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Thyroid investigations - Coggle Diagram
Thyroid investigations
1- Function
T3, T4, TSH
TSH is the most sensitive & used in mild cases toxicity diagnosis
Free T3 & T4 are more accurate than Total
Thyroid Abs
In Hashimoto and Graves disease
TRH
Radiactive iodine
Indicated in toxic goiter (esp. toxic nodular)
Radioactive iodine uptake test
Thyroid scanning
Solitary fromtoxic MNG
2- Morphology
US
TIRAD score
3 repeat US after 6 months
4 suspicious >>>>FNAC
2 Benign ... no need for FNAC
5 highly suspicious >>> FNAC
1 normal
CT
in retrosternal and malignancy
Isotop scan
In toxic nodular goiter ( if diffuse enlargment >> diffuse uptake ... no need for isotop scan)
single ... positron emession (recent)
3- Tissue diagnosis
FNAC
no FNAC in toxic pt
No core cutting biopsy in thyroid .. (fear of RLN injury & bleedig)
Staging and follow up if malignant
Tumor markers
Investigations for metastasis
PET scan
Bone scan is made postoperative except in medullary ( no iodine uptake)