The reliability of the clinical examination of the thyroid gland. A prospective study of 100 consecutive patients surgically treated for hyperparathyroidism.

One hundred consecutive patients referred to us for surgical treatment of hyperparathyroidism were examined for thyroid disorders before and during surgery. Examination during surgery was supplemented by thyroid biopsy or by lobectomy in 49 cases. The sensitivity of clinical examination of the thyroid was 38%, its specificity 100%. Most clinically occult changes were discrete but four patients had nodules of 2 cm or more in diameter. The prevalence of thyroid disorders in our patients was 50%. The question whether this figure can be generalized to the population at large is briefly discussed. Our findings suggest that the sensitivity of clinical examination of the thyroid is low, even in the hands of trained clinicians.