Use of ultrasound in childhood thyroid disorders

Thyroid ultrasound findings in 55 patients aged 6 days to 19 years were reviewed to assess the importance of this technique in evaluating childhood thyroid disorders. Findings were correlated with the available clinical, radionuclide, and pathologic data. In 25 patients with diffuse thyroid lesions (thyroiditis, Graves disease, euthyroid goiter, iodine-induced goiter, goitrous cretinism), ultrasound revealed only homogeneous thyroid enlargement or a nonspecific patchy echo pattern. In two infants with poorly visualized glands on radionuclide scans, ultrasound confirmed the presence of anatomically normal thyroid tissue. Twenty patients had at least one focal thyroid lesion seen by ultrasound, including nodules not detected by palpation in one child or by technetium scan in three. Thyroid malignancies were found in four of 13 patients with solitary thyroid nodules, occurring in two of four patients with echogenic nodules, two of five children with complex lesions, and none of four with echofree nodules. Thyroid ultrasound is a sensitive, noninvasive means of evaluating thyroid anatomy. Because it can detect thyroid tissue in the neck not seen on radionuclide scan in patients at all ages and can define the number and consistency of focal lesions, this technique offers definite advantages in assessing a variety of childhood thyroid disorders.