A primary care approach to the adult patient with nodular thyroid disease

Nodular thyroid disease can be defined as the presence of one or more nodules in a thyroid gland of normal or increased size. To diagnose and treat patients with nodular goiters cost-effectively is often challenging because many thyroid illnesses present with a nodule; often the patient is unaware of its presence. Although most thyroid nodules are benign, it is occasionally difficult to exclude malignant neoplasm in an enlarged gland. It is essential for the primary care physician to be comfortable with examining and treating patients with thyroid nodules. A rational, stepwise approach to the evaluation of nodular thyroid disease was developed.