Physical Exam

Thyroid Palpation

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Video coming September 2026

How to Perform

Standing behind or in front of the seated patient with the patient's neck slightly flexed, gently place the pads of your fingers at the base of the anterior neck in the spaces between the trachea and the sternocleidomastoid muscles bilaterally. Ask the patient to swallow (offer a sip of water if needed) and feel the gland rise with the swallow. Note the size, symmetry, consistency, nodularity, and tenderness.

How to Interpret

Chronic Obstructive Pulmonary Disease

Maximum laryngeal height ≤4 cm

Rule in

Somewhat helpful

Rule out

Minimally helpful

Evidence:Limited

Laryngeal descent >3 cm

Rule in

Not helpful

Rule out

Not helpful

Evidence:Limited

Goiter

Palpably enlarged thyroid (goiter)

Rule in

Somewhat helpfulNo CI

Rule out

Somewhat helpfulNo CI

Evidence:Limited

Thyroid Nodule

Palpable solitary thyroid nodule

Rule in

Not helpfulDerived CI

Rule out

Not helpfulDerived CI

Evidence:Limited

References

Soto Jacome C, Garcia A, Golembiewski E, Loor-Torres R, Duran M, Segura D, Toro-Tobon D, Fan JW, Singh Ospina N, Brito JP. Physical examination of the thyroid: accuracy in detecting thyroid nodules and frequency of additional findings. Endocr Pract. 2024;30(1):31-35. doi:10.1016/j.eprac.2023.10.002. PMID: 37805101.
Campanella P, Ianni F, Rota CA, Corsello SM, Pontecorvi A. Quantification of cancer risk of each clinical and ultrasonographic suspicious feature of thyroid nodules: a systematic review and meta-analysis. Eur J Endocrinol. 2014;170(5):R203-R211. PMID: 24536085.
Cañete EJ, Sison-Peña CM, Jimeno CA. Clinicopathological, biochemical, and sonographic features of thyroid nodule predictive of malignancy among adult Filipino patients in a tertiary hospital in the Philippines. Endocrinol Metab (Seoul). 2014;29(4):489-497. doi:10.3803/EnM.2014.29.4.489. PMCID: PMC4285043.
Cotter A, Jinih M. Thyroid nodule size and risk of malignancy: a systematic review. Discov Oncol. 2025;16:1188. doi:10.1007/s12672-025-02588-y. PMID: 40591129. PMCID: PMC12214072.
Carrillo JF, Frias-Mendivil M, Ochoa-Carrillo FJ, Ibarra M. Accuracy of fine-needle aspiration biopsy of the thyroid combined with an evaluation of clinical and radiologic factors. Otolaryngol Head Neck Surg. 2000;122(6):917-921. PMID: 10828810.
Kuru B, Gulcelik NE, Gulcelik MA, Dincer H. Predictive index for carcinoma of thyroid nodules and its integration with fine-needle aspiration cytology. Head Neck. 2009;31(7):856-866. PMID: 19340874.
Chiofalo MG, Signoriello S, Fulciniti F, Avenia N, Ristagno S, Lombardi CP, et al. Predictivity of clinical, laboratory and imaging findings in diagnostic definition of palpable thyroid nodules. A multicenter prospective study. Endocrine. 2018;61(1):43-50. doi:10.1007/s12020-018-1577-5. PMID: 29569123. PMCID: PMC5997121.
Straus SE, McAlister FA, Sackett DL, Deeks JJ. The accuracy of patient history, wheezing, and laryngeal measurements in diagnosing obstructive airway disease. CARE-COAD1 Group. JAMA. 2000;283(14):1853-1857. doi:10.1001/jama.283.14.1853. PMID: 10770147.
Fatourechi V, Aniszewski JP, Fatourechi GZE, Atkinson EJ, Jacobsen SJ. Clinical features and outcome of subacute thyroiditis in an incidence cohort: Olmsted County, Minnesota, study. J Clin Endocrinol Metab. 2003;88(5):2100-2105. PMID: 12727961.
Trzepacz PT, Klein I, Roberts M, Greenhouse J, Levey GS. Graves' disease: an analysis of thyroid hormone levels and hyperthyroid signs and symptoms. Am J Med. 1989;87(5):558-561. PMID: 2816972.
Siminoski K. Does this patient have a goiter? JAMA. 1995;273(10):813-817. doi:10.1001/jama.1995.03520340069038. PMID: 7861577.

Research last updated September 10, 2026.