Thyroid enlargement / thyroid nodules

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Useful Management Information

In the setting of normal thyroid function, refer to category 1 conditions to general surgery
For patients with a thyroid nodule and abnormal TFT, refer to endocrinology
Thyroid nodules may not require further investigation if:
- thyroid function is normal and no local symptoms and likelihood of thyroid cancer is low (nodule <10mm)
- age, comorbidities or other patient characteristics make diagnosis of thyroid cancer irrelevant
If a nodule is detected on USS, the report should include the TI-RAD score of the nodules and recommended follow-up. If this is not stated in the report, then it is recommended to discuss with reporting radiologist.

Minimum Referral Criteria

Category 1	In the setting of abnormal thyroid function, refer to endocrinology The following conditions are to be referred if accompanied with normal thyroid function to general surgery unexplained hoarseness or voice changes associated with a goitre goitre associated with symptomatic airway narrowing cervical lymphadenopathy associated with a thyroid mass (usually deep cervical or supraclavicular region) a rapidly enlarging thyroid mass over a period of weeks (a rare presentation of thyroid cancer and usually associated with anaplastic thyroid cancer or thyroid lymphoma) lymphadenopathy stridor, venous congestion on elevation of upper limbs dominant nodule >4cm in size abnormal cytology
Category 2	Diffuse goitre, multi-nodular goitre or solitary nodule (<4cm in size)
Category 3	No category 3 criteria
If your patient doesn't meet the minimum referral criteria If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service.

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Previous imaging or cytology results
TFTs – free T4, T3 and TSH results
USS
CXR

Additional Referral Information

Thyroid nuclear medicine scan if thyrotoxic with thyroid nodule
CT neck without contrast if compressive symptoms
Consider FNAC according to TI-RADS score recommendation

Send Referrals To

Smart Referrals

Coming Soon

Internal Referrals

Diabetes/Endocrinology (E-Blueslips)

Fax

5687 4497

Post

Booking and Referral Centre
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

1300 559 083

Service Availability

Facilities

Gold Coast University Hospital

Robina Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.