Patients with thyroid disease may present systemically with disturbance of thyroid function and/or locally as diffuse goiter or a focal thyroid nodule. While the physiological derangement can be assessed by clinical examination and biochemical tests, high resolution sonography is an ideal and non-invasive imaging modality for evaluation of thyroid nodules.

The spectrum of thyroid nodules ranges from the common multinodular change to malignant thyroid tumours. The main aim of imaging is to identify patients with malignant thyroid disease so that prompt and appropriate treatment can be instituted; and to ascertain benignity of other thyroid nodules so that patients can be reassured and managed conservatively.

The major indications for ultrasound of the thyroid gland include:
(1) Characterize nature of thyroid nodule;
(2) Provide real time imaging guidance for fine needle aspiration cytology (FNAC) / biopsy;
(3) Follow-up patients post-operatively to exclude local or regional tumor recurrence;
(4) Evaluate nodal status to accurately stage thyroid cancer

This presentation will review the ultrasound features of the commonly encountered thyroid lesions.