Evaluation and imaging of a thyroid nodule.

The approach to the thyroid nodule has been incrementally modified over the past decade. The widespread adoption of fine needle aspiration in the 1980s, coupled with increased use of serial ultrasound monitoring, arguably led to the biggest changes in recommendations for surgical intervention during the past 50 years. For the office-based practitioner, thyroid nodule presentation patterns are changing with discoveries of more thyroid "incidentalomas" and with new risk assessment challenges associated with small (<1 cm) nodules. At the same time, improved primary evaluation techniques, most notably the increasing use of small, portable ultrasound imaging units, are making many clinicians more comfortable in recommending less invasive follow-up.