In the article we will talk in detail about the diagnosis of thyroid diseases. We will consider the topic as a whole, but we will delve into the diagnosis of various pathologies. We will learn about modern and traditional methods, talk about their advantages and disadvantages.
The thyroid gland regulates the functioning of the nervous and cardiovascular systems through the production of hormones. That is why a lot depends on this little defender. If the work of the gland is disturbed, you should consult a doctor as soon as possible to find out the cause and prescribe treatment.
When is a comprehensive examination necessary?
To begin with, we recall that the symptoms of thyroid dysfunction are almost always the same, so it is rather difficult to confuse them. Firstly, it is discomfort in the neck, fatigue, cough, swelling of the limbs. Also against this background, there is a sharp deterioration in the condition of nails, hair, skin. These symptoms are very often characteristic of a number of other diseases. That is why it is worth initially contacting a therapist so that, based onof the main complaints of the patient, issued a referral to a specific doctor.
The main specialist in dealing with disorders of this gland is an endocrinologist. He, most likely, will prescribe tests for hormones in order to identify inflammatory processes, hormonal failure, or the presence of formations in the gland. However, before making a final diagnosis, the patient will have to undergo many additional procedures.
Often, a study may be ordered due to regular stress, poor nutrition, or environmental intoxication. All this can easily lead to malfunctions of the gland. A pathology in which its functions are weakened is called hypothyroidism. It manifests itself in the form of depression, weight gain, fatigue, constipation. A pathology in which the functions of the gland are too active is called hyperthyroidism. It is manifested by increased irritability, excitability and rapid weight loss with excellent appetite.
Cancer of this organ is manifested by shortness of breath, a feeling of constriction in the neck. The lymph nodes also swell, the voice is hoarse. Of course, such symptoms can occur with other diseases, but after an examination by an endocrinologist, it is better to undergo a comprehensive examination.
Sequence
Diagnosis of the thyroid gland consists of a number of complexes of laboratory and instrumental studies. Initially, the simplest method is used, namely palpation. After that, the patient is sent for an ultrasound examination. If a tumor is suspected, a puncture should be performedand scintigraphy. It is also very important to get tested for hormones produced by the thyroid gland. Their imbalance can indicate the real cause of the violation.
Palpation
The simplest diagnosis of thyroid disease is an examination. An experienced doctor can determine the mobility and size of the gland. He can also determine the presence and location, and even the nature of the goiter. Recall that it can be nodular or diffuse.
During the diagnosis, the doctor grabs the neck and gently presses on the gland area. For the patient, this procedure is almost painless, but it allows you to establish a diagnosis with an accuracy of 60%. In this case, palpation of the lymph nodes is mandatory. So, if they are enlarged in size against the background of low tooth mobility, then this may indicate the presence of cancerous tumors.
Note that there are 6 levels of gland size. At level 0 it is of normal size, but at level 5 it can be quite large and make breathing very difficult. In this case, the doctor should check whether the gland is squeezing into the carotid artery.
Ultrasound
Ultrasound diagnosis of the thyroid gland allows you to determine the contours of the body, the homogeneity of its tissues and structure. Thanks to ultrasound, you can find out about the presence or absence of neoplasms. Such data are necessary for the doctor to make a final diagnosis. Thanks to this research method, it is possible to determine focal or diffuse disorders occurring in the organ. Diffuse disruption means thatthere is a change in the structure of the entire gland. Such a pathology can be detected even with palpation. The doctor may notice an increase in the volume of the organ.
Focal pathologies mean nodes of inflammation in which there is an overgrowth of tissues. In this case, pathologies can be complex or diffuse-focal, which is quite common. The results of ultrasound suggest the presence of adenoma, nodular goiter, thyroiditis, cysts, cancer. However, this method cannot guarantee the accuracy of the diagnosis. It focuses on the external assessment of the condition of the gland. In order to find out the nature of the course of certain processes, it is necessary to examine the level and ratio of hormones. Sometimes a tissue biopsy may be needed.
Note that in the early stages of diagnosing oncological pathologies, electrography is performed. This is also an ultrasound diagnosis of the thyroid gland, which allows you to find out about the density of tissues. Thus, the neoplasm can be identified at the initial stage.
Ray methods
As we know, the thyroid gland is a lobular organ located in the middle of the neck. It consists of two lobes on each side, which are connected by an isthmus. In many people, it is absent or is a thin strip of fibrous tissue. Note that the size and volume of the gland may vary depending on gender and age.
Radiation diagnostics of the thyroid gland is a whole complex of actions, which includes radiography and computed tomography. X-ray can showthe presence or absence of certain neoplasms, as well as the deposition of calcium s alts. As in the previous diagnostic methods, with the help of an X-ray examination, you can find out about the location and size of the gland. The advantages of this method is that the picture is a documentary diagnostic paper and it is static. The disadvantage of this method is that during such an examination, the body receives a certain amount of radiation. Although it is insignificant, such research is often not worth doing.
Computed tomography is a modern method of research. However, this method is used to study cells. This method is effective if the gland exerts strong pressure on neighboring organs, and also when it is necessary to evaluate the method and need for surgical intervention. At the same time, computed tomography can show the exact location of neoplasms.
MRI is a method that is absolutely safe for the body. This is an expensive procedure, but it does not expose the diseased organ to additional radiation exposure. As a result, the specialist receives a post-sectional image, which can detect the size and location of even small formations, changes in the shape and structure of the gland.
Cytological diagnosis of the thyroid gland
Material for cytological examination is obtained by puncture of the thyroid gland. This is a simple and fairly cheap way, which is also painless. This preoperative method allowsmorphological verification of a certain process. Often, cytological examination is carried out in parallel with histological. The goal of the first is to reduce the number of mandatory operations that are performed on patients without neoplasms. It is also often used to prevent malignant lesions. At the same time, he gained great popularity because the cases when patients are operated on have increased, even if there is no particular need for it. The fact is that with such an intervention, the risk of various complications increases.
Indication for cytological examination is a tumor. Also, a study by this method is prescribed for nodular formations. In principle, for any minor pathologies, it will be correct to conduct such a study of the organ in order to outline a specific treatment plan. That is why surgeons, cytologists and endocrinologists must work together. The essence of their work should be a comprehensive diagnosis based on different levels of research.
Let's consider how the puncture is performed. The patient should take a horizontal position. He is not allowed to speak or swallow. The specialist uses 23 gauge needles to pierce the neck. In this case, local anesthesia can be used. The value of such an analysis is greatly increased if the material is immediately evaluated by a cytologist. To obtain the most accurate diagnosis and exclude the possibility of malignant formation, at least two punctures are performed.
Differential diagnosis of thyroid gland
Differential diagnosis implies different methods of diagnosing the thyroid gland. Such a study is necessary if it is difficult to make an unambiguous diagnosis. In this case, the endocrinologist must carry out the maximum number of measures in order to determine the disease. He can involve other specialists who will help him with this. Differential diagnosis involves the use of various techniques in order to achieve an early diagnosis or avoid surgery. Such following is quite popular and modern, but at the same time it is expensive.
Other methods
Now let's look at other methods for diagnosing the thyroid gland in more detail. Scintigraphy is often used. This is a method in which radioisotopes are injected into the body. They accumulate in the gland, and then appear on the pictures after using gamma cameras. Thus, the specialist receives a three-dimensional model of the organ, on which the accumulation of radioisotopes is clearly visible. This diagnostic method is especially useful for cancerous tumors. Harmful isotopes are very quickly excreted from the body with the help of feces and urine.
Tissue biopsy is a well-known cellular diagnostic method that is used when cancer is suspected. Thanks to this method, it is possible to determine the nature of neoplasms with absolute accuracy. The principle of this method is that a sample of thyroid tissue is taken from the patient. Using a special game, the doctor makes several punctures in the neck area and passes the resulting material to the cytologist. In fact, a biopsy and a puncture are one and the sameprocedure.
Laboratory diagnosis of the thyroid gland
Note that this organ produces 2 main hormones T3 and T4, which are necessary for the body for proper metabolism. In this case, the pituitary gland produces thyroid-stimulating hormone, which affects the functioning of the gland. It is also necessary to take an analysis for it, because problems with the thyroid gland can be caused by malfunctions in the brain.
There are three kinds of analysis. The first is radioimmunoassay, which is the most common and accurate method. The patient takes venous blood, which is later mixed with a radioactive reagent that can bind to the hormone. After some time, free and bound substances are separated and the results determined. The second type of analysis is luminescent. In this case, venous blood is also taken from the patient and exposed to ultraviolet light. After that, the laboratory assistant calculates the amount of the desired hormone using a fluorometer. And the third type of analysis is enzymatic. It is necessary to determine the concentration of thyroid hormones. In this case, venous blood is also taken, which is mixed with the reagent.
Nodal pathologies
Nodes can form in different parts of the gland. They are asymptomatic, so most often they are discovered quite by accident. At the same time, nodal pathologies are very common. For their diagnosis, palpation, ultrasound, laboratory tests are used. Sometimes a needle biopsy is performed, which can give very accurate results.
We have reviewed all methods for diagnosing thyroid diseases. From this we can conclude that at the moment there are modern methods that allow you to find out about the state of this organ without surgical intervention. At the same time, ultrasound diagnostics of the thyroid gland remains the most popular research method. In principle, there is nothing wrong with this method, since it gives fairly accurate information. However, treatment depends on the diagnosis of the thyroid gland, so you should be very careful about this issue and consult the best specialists.
Remember that doctors advise every year to visit the endocrinologist's office. Moreover, it is recommended to undergo a diagnosis of thyroid diseases and take tests, even if there are no special indications for this. Starting from the age of 25, every year it is necessary to undergo a comprehensive examination. Timely tests and diagnostics of the thyroid gland will help to avoid a huge number of problems.
People at risk should pay special attention to their he alth. These are adults and those who have had cases of thyroid diseases in the family. You also need to be careful for those who live in radiation zones and are susceptible to irradiation of the head and neck. Remember that even a detected node may turn out to be colloidal, and then no treatment is needed. You should not remove such an education, since it is not dangerous for he alth. But at the same time, there may be a serious education, from which it is possible to successfully recover only at the beginning.way.
