title: Clinical and thyroid ultrasound evaluation in an asymptomatic adult Puerto Rican population: The San Juan city hospital experience Coromoto A. Pale.
abstract: OBJECTIVE
  to determine the prevalence of thyroid disease in an asymptomatic Puerto Rican adult population within an iodine sufficient area. Correlate the clinical thyroic features during palpation with thyroid sonographic findings. Relate gender, laboratory data, and family history with the presence or absence of thyroid pathology.
  
  
  METHODS
  Cross-sectional, descriptive, comparative study performed during the period of February 2008-January 2009 in an asymptomatic Puerto Rican copulation. The study sample size consisted of 110 adult participants, employees of the San Juan City Hospital in apparent good health. A questionnaire emphasizing relevant personal and family thyroid pathology (benign and malignant) was obtained. A complete physical examination was performed emphasizing thyroid gland palpation, utilizing a posterior approach. for detection of any abnormal thyroid features. All participants underwent thyroid ultrasonographic (US) examination and blood sampling for ultrasensitive TSH and antiperoxidase antibodies. Subjects with thyroid nodules over one centimeter, found on thyroid US, were encouraged to undergo fine-needle aspiration biopsy (FNAB).
  
  
  RESULTS
  The prevalence of thyroid pathology detected by palpation was 52.72% and 38.23% by US. The most frequent thyroid pathology found on palpation was goiter (41.37%) and multinodular goiter (64.85%). Twenty-four percent (24%) of the participants with normal findings on palpation had abnormal findings by US and 33.33% of those met criteria for FNAB. In sixteen patients with abnormal US, only six agreed to have FNAB, all were reported negative for malignancy.
  
  
  CONCLUSIONS
  Our results suggest that routine thyroid US should be seriously considered for all patients with suspected thyroid disease. Statistical analysis demonstrated a significant correlation between palpation findings performed by an experience physician and thyroid ultrasonography results. Even in patients with negative family history of thyroid pathology, abnormal thyroid ultrasound abnormalities were detected in 35.73%. To our knowledge this is the first study done in Puerto Rico, comparing thyroid palpation and ultrasonographic findings.
authors.affiliation: Internal Medicine Program, San Juan City Hospital, San Juan, Puerto Rico. coropalermo@caribe.net
authors.forename: Coromoto A
authors.initials: CA
authors.lastname: Palermo-Garofalo
authors.forename: Maria
authors.initials: M
authors.lastname: de Lourdes Miranda
authors.forename: José H
authors.initials: JH
authors.lastname: Martinez
authors.forename: Oberto
authors.initials: O
authors.lastname: Torres
authors.forename: Eva
authors.initials: E
authors.lastname: Gonzalez
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D015995:Prevalence; D011647:Puerto Rico; D016606:Thyroid Nodule / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D014463:Ultrasonography