Incidental thyroid nodule

Patel and colleagues tell us that incidental thyroid nodules are
increasingly
detected during imaging of the neck for other indications. I have seen patients who have had carotid artery
ultrasonography as part of a private health screen in which mixed thyroid nodules have been detected and they have been recommended for review by their general practitioner.

In the absence of evidence-based guidelines I have contacted the local
radiology
department for advice on further management. Perhaps understandably, they
were unhappy to comment on the report because they had not carried out the

original scan. They suggested the health screening company had a duty of
care to follow the patient up. When I contacted the company they advised
me
to refer patients locally for formal ultrasonography of the thyroid
gland.

Private health screening is likely to contribute to the number of
incidental
thyroid nodules detected during neck imaging, and the responsibility and
cost to investigate these will fall on the NHS. Incidentally, some private health screens for cardiovascular risk factors do not include a
simpler
and cheaper blood test for cholesterol
and glucose.

Competing interests:
None declared