Choosing wisely: only do it on palpable thyroid mass

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Ultrasound Features of Primary Suggesting Malignancy (red = high risk)

Ultrasound Features of Lymph Nodes Predictive of Malignant Involvement

*Opposite to the primmary apart from ‘micro-calcification’

Sign Reported sensitivity, % Reported specificity, %
Microcalcifications 5–69 93–100
Cystic aspect 10–34 91–100
Round shape 37 7
Peripheral vascularity 40–86 57–93
Hyper-echogenicity 30–87 43–95