Ultrasound : So I had my scan earlier but the... - Thyroid UK

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Ultrasound

Suecoo66 profile image
34 Replies

So I had my scan earlier but the consultant radiologist didn't tell me anything and just said you need to speak to your Dr which made me feel concerned. He asked how long I've had the swelling on my neck.

Can you use the scan to diagnose hypothyroidism or is it to look for tumours?

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Suecoo66 profile image
Suecoo66
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34 Replies
PurpleNails profile image
PurpleNailsAdministrator

Radiologist always say discuss with GP. It so they can save time & later review the images and write report.

The only time I was told something at the time was when the team told me I have a very large nodule and had time there & then to complete a Fine needle Aspiration.

Then the full report was letter sent later to GP.

Ultrasound scans look at the size & health of thyroid. They can detect nodules & from the images usually see any indication of autoimmune damage and changes to vascularity which can be present with thyroid conditions.

It can’t conclusively determine function, (only indicate) which is why blood tests are used in conjunction to assess thyroid levels.

My hyper levels was missed as the nodule was biopsied and determined as benign but according to subsequent notes “patient did not return for thyroid function blood test” not true - I had attended for blood test & even phoned to specifically ask if was my thyroid ok. Was told normal - no further action. But the thyroid part hadn’t been processed. I didn’t know to insist on viewing my own results so it was missed for another 7 months .

I had a further uptake scan which does examine thyroid function but this often only done if the cause of hyper is not autoimmune.

Hedgeree profile image
Hedgeree

Hi Suecoo66,

I recently had a thyroid scan after being referred by an NHS endo. The person that did the scan was really helpful and actually told me briefly that she had found a large nodule on my thyroid. (This didn't come as a surprise though as I have an obvious swelling, my voice is hoarse and have a lump in throat feeling.)

She said she thought it cruel to not say something though she did say that many don't and have to wait for the gp to contact them. She also emphasised how worrying it is to have to wait to find out the results so I think she was trying to be kind.

As PurpleNails says they always refer you back to your gp or whoever referred you for the scan. It is a worrying time as I know from my own experience as I'm still waiting for the full results but at least I know it's not me imagining things. I'm now waiting for the Fine Needle Aspiration appointment.

It's difficult not to worry at these times and it can take a few weeks for the scan results to be with your gp.

Take care.

Suecoo66 profile image
Suecoo66 in reply toHedgeree

The Dr was really quite arrogant I thought, the most unfriendly person I've come across! I tried to ask questions and he wasn't giving any info at all. He said he was sending it immediately but when I asked at the reception for my GP they said it hadnt come yet. She did say that my appointments to see endo and ENT could take months so I'd really like to know the results or my scan!

Hedgeree profile image
Hedgeree in reply toSuecoo66

Oh no that sounds like a horrible appointment.

It seems I've been quite fortunate so far as all the people that I've been seeing have all been friendly and approachable, especially the person that did my thyroid scan. Although it has taken two years to be taken seriously, gp rubbish.

Take care. Hope you get your results soon.

Suecoo66 profile image
Suecoo66 in reply toHedgeree

He even was rude when I turned my head towards the screen and more or less shouted at me to look up. I'm sure most people who have these scans must feel anxious about the outcome.

Batty1 profile image
Batty1 in reply toSuecoo66

He shouted at you to look up from the screen that contained your health information….Did you tell him to this screen contains my info and I will look at it if I want ….Awful!

Suecoo66 profile image
Suecoo66 in reply toBatty1

I was looking at the monitor as he was doing the scan, still had my chin up as he had instructed earlier but to 1 side slightly. Made me feel like a naughty kid!

Suecoo66 profile image
Suecoo66

Finally managed to speak to someone in the GP surgery about the scan. She read it and said I don't understand what it says and rushed off to speak to the duty Dr. Came back and said it basically says your goiter is enlarged but it nothing sinister. Well I already knew that it's enlarged so still none the wiser!

PurpleNails profile image
PurpleNailsAdministrator in reply toSuecoo66

Ask for copy of the report.

The GP can provide a copy. I get to view documents of what the GP holds on my online access. Receptionist should be able to print.

If for any reason practice are obstructive you can obtain direct from hospital. Department secretary or most hospital website have a data co ordination contact you can usually contact for application for to obtain.

It must say a little more that “enlarged goitre but nothing sinister” or the 1st doctor would have understood it. (You would hope). It’s likely nothing worrying and so doctor hasn’t gone into detail, but it might be nice for you to know.

Suecoo66 profile image
Suecoo66 in reply toPurpleNails

How do you get a copy from the hospital? I wish I'd asked the receptionist now.Our Dr doesnt let you access anything online which is annoying

PurpleNails profile image
PurpleNailsAdministrator in reply toSuecoo66

If you are in England practices are contractually mandated to provide online access to your medical record. Outside England do not have sane arrangement so vary but if are in UK you should not be refused.

You can verbally request test and documents from GP and they can provide. Some are obstructive and say you have to apply or put request in writing.

When I was obtaining my blood test results from endocrinology I would ask for department secretary to post me a copy, but they were the team requesting the test.

It’s possible the department where you had the appointment eg radiology / ultrasound department will say report goes to GP. ie from who arranged the referral. Although there nothing to stop you asking for a copy to be sent to you too.

Failing that most hospitals have a medical records coordinator which can be found on the hospital website. It might be listed as health records department / library. If not on website would try the switchboard and ask it there’s a records department.

Hospitals usually have their own application form where you can request single, or entire record. I have done both. The single record was emailed back quite quickly. The full record being a larger record was posted. ID and a witness signature is required which I was able to submit via email. Photo copies via post & can be used too.

Suecoo66 profile image
Suecoo66 in reply toPurpleNails

Yes I'm in England but there is no way of accessing GP records online

PurpleNails profile image
PurpleNailsAdministrator in reply toSuecoo66

If practice are saying there’s no way of setting up access they are in breach of their contract.

Suecoo66 profile image
Suecoo66 in reply toPurpleNails

The only thing I can do online is order a prescription, some very basic appointments can be booked but that's it

PurpleNails profile image
PurpleNailsAdministrator in reply toSuecoo66

That’s because the initial request for online access it set up to allow a basic access only. Often only coded record, prescriptions & appointments.

Speak to the practice staff & and request they set the options to allow full access including historical record. Practice staff must set parameters to your DOB not - date of request - as then the prospective records will be included.

Full access can sometimes be requested via the system itself. if you are using for example the TPP system there’s an “account” section where you can “manage online services” and here you can add or remove the additional options.

It might say “not available” but there should be option to request. It just need to be set up by practice.

Suecoo66 profile image
Suecoo66 in reply toPurpleNails

What's the TPP system?

PurpleNails profile image
PurpleNailsAdministrator in reply toSuecoo66

One of the user systems, there are several but systmonline run by TPP Is one of the mostly used one.

What way do you access prescriptions & appointment, eg website name or app?

Suecoo66 profile image
Suecoo66 in reply toPurpleNails

Usually the NHS app but before that the Patient Access app. I didn't know there were any others. To use Systmonline do I need to get a log in from the surgery?

PurpleNails profile image
PurpleNailsAdministrator in reply toSuecoo66

There is a settings options in the NHS app upper right corner (three dots) and this takes you to account settings but I’m not very familiar with how it works from there.

I think the best option it to speak to practice as ultimately they are the ones to apply the correct settings.

Patient access isn’t available in my area. I think includes hospital records if set up (I’m not entirely certain on that one).

There many different apps which can be used across the different systems practices uses.

DJR1 posts about access to records. You may find more information in those post

healthunlocked.com/user/DJR...

Suecoo66 profile image
Suecoo66

Final got a copy of my report emailed to me and fuming with the receptionist who told me it was nothing. This has just made me more concerned.

Ultrasound report
PurpleNails profile image
PurpleNailsAdministrator in reply toSuecoo66

How appalling. Report states “referral to ENT” but you are told basically goitre nothing to worry about?

Why doctors don’t explain fully, then you wouldn’t worry, are they arranging referral or have they decided everything ok based on the rest of the report?

Breaking down the report comments:

Right lobe nodular. With cystic (fluid filled) & colloid (solid tissue)

61 X 40mm in size - This is large. Generally nodules over 1cm are biopsied, but if the area is of different / patchy nature they may argue the isn’t a single cystic or solid area to aim for.

I would be pushing for fine needle aspiration. Especially as it is described as unusual U2/U3.

U 1-5 is ultra sound classification for thyroid nodules. U2 meaning nodule present. U3 being indeterminate (and therefore FNA to investigate further). U4 is suspicious & U5 is malignancy.

“hyperaemia” refers to increased blood flow or vascularity. They look for this as it’s commonly seem with Hashimoto’s & Graves thyroid conditions. You do not have abnormally increased blood flow.

Thin isthmus (bridge between lobes). They mention this to confirm it’s been reviewed & not overlooked.

Other lobe is small.

No obvious parathyroid lesion. Normal submandibular (saliva) glands. No significant cervical lymphadenopathy (lymph nodes). (All good things.)

Ultrasound doesn’t determine thyroid function, your thyroid result were showing low TSH.

Low free T4 14.6 pmol/L (12.0 - 22.0). 26% of range

And just above mid range for FT3

Serum free T3 5.2 pmol/L (3.1 - 6.8) 56% of range

So function is unusual too as you would expect in range thyroid hormone to have in range TSH.

Test thyroid antibodies TPO, TG if they suspect Hyper based on TSH (doctor often do) you need TRab and TSI tested.

If Antibodies negative you need a thyroid uptake scan to carefully examine function through out the thyroid that will explain what’s going on.

Function of thyroid will be looked at by endocrinologist. Physical issues with Thyroid are examined by ENT or radiology. So you may even be referred to 2 departments.

Suecoo66 profile image
Suecoo66 in reply toPurpleNails

Yes I was referred to both on 11th March prior to the ultrasound but last time I asked I was told by the receptionist at the GP they are taking months. Now I've read it I'm going to get back in touch with the GP and try and get another appointment to ask about a FNA.

Suecoo66 profile image
Suecoo66 in reply toPurpleNails

It was the receptionist who said this after walking down to talk to the duty doctor. She said dont worry its nothing sinister just your goiter is enlarged which obviously I already knew based on the swelling in my neck!

PurpleNails profile image
PurpleNailsAdministrator in reply toSuecoo66

From the report though the thyroid is not enlarged (goitre). So what you were told was not accurate - you have a large nodule and a small lobe.

although there no extremely worrying comments in the report. I’d would be annoyed about not being referred as suggested and explained why straight away. They just picked out that it’s not U4/5 so nothing to worry about.

Now you have the scan report you know up need it followed up. Try not to worry.

Suecoo66 profile image
Suecoo66 in reply toPurpleNails

I have been referred by my GP prior to having the scan. When I saw him on 11th March he ordered the scan and also did the 2 referrals. Is it possible they are cysts? Worried me the size and the unsual appearance. My Dad had Hodgkins and the 1st sign was a neck lump so now feel paranoid

PurpleNails profile image
PurpleNailsAdministrator in reply toSuecoo66

So you have a referral ENT and referral to endocrinology. Did ENT arrange the scan, as the report say referral to ENT?

I had swollen submandibular gland last year hospital declined direct to scan - so I had to have and appointment with ENT before and then after scan. (Waste of time) then they discharged me saying all normal. Then they arranged another scan, I was worried but it was all for a trainee to practice on. I find transport and child care an issue so I was not pleased.

So hospital do a lot of passing around and apparent wasting time. (I’m still cross about it)

Cystic areas are small cysts but are within the nodule by the sound of it.

Hodgkin involves the lymph glands and they were noted to be normal.

Suecoo66 profile image
Suecoo66 in reply toPurpleNails

The Dr who did the scan obviously doesn't know my GP has already referred me. I haven't seen ENT or endocrinology yet or even had an appointment though.

PurpleNails profile image
PurpleNailsAdministrator in reply toSuecoo66

Good, you have a appointment in process, that’s something.

Suecoo66 profile image
Suecoo66 in reply toPurpleNails

Just could take months before I actually get one

Suecoo66 profile image
Suecoo66 in reply toPurpleNails

UpdateI've phoned the hospital and told referral was received 7th April despite being told by GP surgery it was done 11th March (day of my appointment)

I advised I was concerned about US scan I'd had since the referral and she advised that I ask the GP to expedite the referral as it was currently booked in as routine.

I've now emailed them to ask that my GP do this and the reply was that they'd sent him a message which he'd see tomorrow when he's in. Odd as on the phone when I asked for an appointment they told me he's not in all week and I'd have to see the nurse.

PurpleNails profile image
PurpleNailsAdministrator in reply toSuecoo66

Well done. They should be able to say as ultrasound competed and says unusual referral suggested that supports expediting referral

Suecoo66 profile image
Suecoo66 in reply toPurpleNails

Finally had my appointment today which wasn't great.The Dr had very broken English, spent more time looking at my husband speaking to him than me and looked up the odds of me having cancer online.

He is however referring me for a urgent FNA so now have to go back to see the grumpy git at Ultrasound who will perform this. Hoping its done before the 4th June as I'm in Turkey visiting my daughter from then until the 25th June.

Just hoping the FNA isn't too painful.

PurpleNails profile image
PurpleNailsAdministrator in reply toSuecoo66

I can reassure you it’s a straightforward quick process, by guided ultrasound. I was given a local anaesthetic & discomfort minimal. Sometimes very confident & quick doctors do complete without local. Ask beforehand what they plan to do.

I was told gently bite end of my tongue, this is to minimise swallowing & movement. Once numb the needle is passed a few times. I was able to work a busy 3 hour shift after procedure as was only expecting a scan. The worry about having it would probably have been far worse.

19 per of 20 samples do not require follow up. (& I didn’t have to look that up)

Sample Collection failure can be quite high, more so with solid areas.

Suecoo66 profile image
Suecoo66

Having an absolute nightmare with Dr's & hospital. GP agreed to expedite my referral to ENT as urgent following me emailing him after I saw my scan report. Shows he hadn't even looked at it or surely he'd have done it himself & not need me to ask. Hospital appointments told me twice they've not received it but after finally speaking to ENT they say they did get it but it's currently still showing as routine. Took my number but told me they can't make any promises. What an absolute joke! No wonder people are dying

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