MEHMET İHSAN GÜLMEZ, AND CANSET AYDIN
ENT Updates - 2025;15(3):42-48
This study is part of the health project called “Health screening for the elderly in Ankara” for patients aged 65 and over, with 1200 participants. Patients with missing laboratory tests (n = 59), movement disorders and/or bedridden (n = 54) were excluded from the study. PE was performed by a geriatrician or an ear, nose, and throat surgeon, and ultrasonographic evaluation was performed by a radiologist. PE and USG findings were compared. We aimed to investigate the diagnostic accuracy of physical examination (PE) of the thyroid gland (TG) in patients over 65 years of age and to assess the reliability by comparing PE with ultrasonographic (USG) examination. The median age of the patients participating in the study was 71.17. When the differences between thyroid nodules (TN), the number of TN size, and goiter detection were compared in terms of PE and USG, all values were statistically signi ficant, and P values were < 0.001. The sensitivity of PE of TG was calculated as 31.0%. In our study, the sensitivity of PE of TG in terms of TN and goiter was found to be low. The diagnostic accuracy of PE of TG is low, and therefore, its impact on clinical decision-making is limited. Furthermore, detected nodules rarely progress to clinically relevant disease, leading to overdiagnosis and overtreatment. Especially in groups at risk for nodules and malignancy, PE must be combined with imaging methods and, if necessary, pathological examination, even if nodules or goiter are not palpable in PE. Highlights: The clinical features of thyroid disease are altered in older people, so that the symptoms and physical findings may be different and less prominent than in younger people, or may even be absent. TNs have a prevalence of 4% in the general population based on PE and ≤ 50% based on USG or direct visualisation during surgery, and ≤ 100% in autopsy series. An important finding of the present study is that as the size of the thyroid increases, the ability to palpate TNs also increases. Thyroid PE should always be combined with imaging and, if necessary, histopathology in those at risk of TNs and malignancy, even when TNs or goiters are not palpable.
