Radioiodine imaging in the primary care of thyroid disease.
There are few indications for ordering a RAIU or a thyroid scan in a primary care setting. In suspected hyperthyroidism, a sensitive thyrotropin assay should be the initial test ordered. If the thyrotropin level is low or suppressed, and the diagnosis of thyroiditis vs Graves' hyperthyroidism is not clear, a RAIU test is appropriate. In the case of a euthyroid nodular goiter, fine-needle aspiration is the most accurate initial test to evaluate for malignancy. The primary indication for a scan in the case of a euthyroid nodular goiter is a low or suppressed thyrotropin level, because malignancy is rare in a hot nodule. If thyroid cancer or congenital hypothyroidism is encountered, referral to an endocrinologist is probably the most expedient and cost-effective way to proceed.
Wu
Sharon Y
SY
Rush University Medical Center, Chicago, USA.
Weiss
Roy E
RE
D006801:Humans; D007457:Iodine Radioisotopes; D011877:Radionuclide Imaging; D013959:Thyroid Diseases / Q000000981:diagnostic imaging*
D007457:Iodine Radioisotopes