palpation from behind
Last reviewed 01/2018
Palpation is best done from the behind with the patient's neck slightly flexed to relax the sternomastoid muscles. Both hands are placed with the fingers over the gland, feeling for both lobes of the gland and its isthmus.
The sternomastoid may be pulled back with the fingers.
- estimate the size and feel for the lower border of the thyroid; absence may signify retrosternal extension
- shape - nodular or multinodular
- consistency:
- soft is normal
- firm - simple goitre, Hashimoto's
- stony hard - carcinoma, calcification, cyst, fibrosis, Hashimoto's
- woody and tender - acute thyroiditis
- tenderness - suggests thyroiditis
- mobility - carcinoma may tether the gland.
Measurement accurately charts the size.
Localised swellings may be better defined from the front.