Wednesday, December 29, 2021

Thyroid nodules in the elderly

 My doctor referred me for a scan after my fall checkup because she found something on my thyroid with palpation. Then when I had my auto accident on November 26 the scan of my head found a good size nodule and the scan in December found two.  So now I have a consult in January.  Here's what I found when I checked out thyroid nodules in the elderly.

"Thyroid nodules are more frequent in elderly patients, with a linear increase with age in both the presence of nodules and the absolute number of nodules per patient (). Approximately 50% of individuals aged 65 years have thyroid nodules detected by ultrasonography (). A cross-sectional survey of asymptomatic adults in Germany using ultrasonography to detect thyroid nodules demonstrated an even higher prevalence of 80% in women and 74% in men over 60 years old (). In a prospective study of 6,391 patients referred for thyroid nodules at a large academic center, Kwong et al. showed a linear increase in the number of thyroid nodules per patient with age, rising from an average of 1.55 nodules ≥1 cm in patients age 20–29 years old to a mean of 2.21 nodules ≥1 cm in patients ≥70 years old, demonstrating a 1.6% annual increased risk for multinodularity ().

Another potential contributor to this rising prevalence of thyroid nodules is the increased use of high-frequency ultrasound, CT, and MR imaging in routine clinical care, leading to the detection of asymptomatic, or incidental, thyroid nodules (,,,). Lastly, changes in population demographics over time, specifically increased rates of obesity, may contribute. Data from several ethnically diverse cohorts has identified parameters independently associated with the development of thyroid nodules, including obesity, female sex, radiation exposure, iodine deficiency, and smoking. These should be noted when evaluating elderly patients for potential thyroid nodules ().

Once identified, thyroid nodules should be evaluated to determine appropriate management. The differential diagnosis of thyroid nodularity includes benign and malignant solitary nodules, multinodular goiter, autonomous functioning nodules, cysts, and inflammation or thyroiditis (). Nodules causing thyroid dysfunction, compressive symptoms, or harboring malignancy require attention."

Thyroid Nodules and Cancer in the Elderly - Endotext - NCBI Bookshelf (

If it weren't for doctors' visits I'd have no social life.

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