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Susan J. Mandel, MD, MPH, Discussant

JAMA. 2004;292:2632-2642.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

DR REYNOLDS: Mrs G is a 64-year-old woman from Brazil with an incidentally discovered thyroid nodule. On a routine visit for follow-up of her multiple medical problems, Mrs G’s primary care physician palpated a left-sided thyroid abnormality.

Mrs G had a right-sided cold thyroid nodule resected in Brazil several decades ago; she became hypothyroid and has been receiving thyroid replacement therapy. During the past 10 years here in the United States, her thyroid-stimulating hormone (TSH) level has always been within normal limits, and her thyroid exam has been either unremarkable or not documented by her physicians. Then, during a recent annual examination, Mrs G’s doctor felt a left-sided thyroid nodule on the background of an enlarged gland. Mrs G’s thyroid function was normal. A thyroid ultrasound suggested a previous right partial thyroidectomy, a small amount of residual right-sided gland, . . . [Full Text of this Article]

MRS G: HER VIEW

THE PRIMARY PHYSICIAN: HER VIEW

AT THE CROSSROADS: QUESTIONS FOR DR MANDEL

The Problem of Thyroid Nodules

Epidemiology

Differential Diagnosis

Diagnostic Evaluation

Role of Ultrasonography

Recommendations for Nodules With Benign Cytology

Summary and Recommendations for Mrs G

QUESTIONS AND DISCUSSION

AUTHOR INFORMATION

Author Affiliations: Dr Mandel is Associate Chief for Clinical Affairs, Division of Endocrinology, Diabetes, and Metabolism, Hospital of the University of Pennsylvania, and Associate Professor of Medicine and Radiology, University of Pennsylvania School of Medicine, Philadelphia.

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