ENDOCRINOLOGY at J|medical

In case of hormonal imbalances, symptomatic or discovered during routine medical exams, or for already ascertained endocrine pathologies, it is necessary to turn to the specialist in endocrinology.

What is endocrinology? It is the branch of medicine that deals with diagnosis and treatment of problems regarding endocrine glands, i.e., secreting hormones. Among these, the most frequently involved are the thyroid, pancreas, adrenal glands, parathyroids, pituitary gland, and gonads. The endocrinologist specialist also deals with metabolic diseases and osteoporosis.

So what does the endocrinologist specialist do? During the visit, they collect all information regarding the patient’s pathology and, if necessary, may choose to integrate the information in their possession with an ultrasound study of the involved gland or with other targeted checks. For some thyroid pathologies, some minimally invasive procedures are available for diagnostic (biopsy, cytological exam, needle aspiration) or therapeutic purposes.

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• Endocrinological visit. To identify and treat hormonal disorders, growth problems, metabolic alterations, diabetes, thyroid disorders, reproductive system disorders, and other problems linked to the endocrine system, an endocrinological visit is recommended. It is a specialized medical consultation in which an endocrinologist evaluates and manages potential problems related to hormones and endocrine glands.

• Ultrasound-guided thyroid/neck biopsy. It is a medical procedure that uses ultrasound to guide the needle during the taking of a tissue sample from a nodule or a suspicious area in the thyroid or neck (biopsy). The operation has the purpose of obtaining a tissue sample for analysis under the microscope, in order to diagnose or exclude pathological pictures.

• Cytological and microhistological examination. These are two types of analysis of tissue samples taken to evaluate the presence of anomalies or diseases. Regarding the cytological examination, cells are collected via scraping or sampling with a thin needle and then analyzed under a microscope. For the microhistological examination, instead, small fragments of tissue are taken via biopsy or needle aspiration.

• Plicometry. It is a technique used to measure the thickness of subcutaneous adipose tissue (fat) in different parts of the body. The data obtained are inserted into mathematical formulas to estimate total body fat and, subsequently, are used to evaluate body composition (i.e., the amount of fat present compared to lean mass) and monitor any changes over time.

• Impedance evaluation. Consists of the use of low-intensity electric current that is passed through the body using electrodes positioned on the skin. Electrical resistance is influenced by the amount of adipose tissue present and allows obtaining an approximate estimate of the percentage of body fat, as well as other measurements such as lean mass and body water.

• Bone densitometry for osteoporosis study and total body densitometry for body composition study.

• Neck ultrasound. Another extremely useful diagnostic and evaluative method is the imaging procedure that uses high-frequency ultrasound to visualize glands and organs. In the case of neck ultrasound, it is useful to examine the thyroid glands, to detect nodules, cysts, enlargements, or other anomalies. It can also be used to evaluate other structures of the neck, such as salivary glands or lymph nodes.

• Salivary gland ultrasound. Always with the ultrasound technique, it is possible to obtain important information on salivary glands and surrounding tissues. The goal is to evaluate the size, shape, structure, and any presence of anomalies in the salivary glands.

• Lymph node ultrasound. The ultrasound study of lymph nodes (at the neck level or in other districts) is useful in case of swellings or other pathological pictures, and informs us about the conditions of the lymph node glands. It allows studying any lymphadenopathies and evaluating their reactive or malignant nature, often in association with other diagnostic exams.

• Parathyroid ultrasound. This exam aims to visualize the parathyroid glands (small glands located in the front part of the neck, near the thyroid), responsible for controlling calcium levels in the body. Such exam is used to evaluate the size, shape, and appearance of the parathyroid glands. The purpose is to identify any anomalies or pathological pictures. It is a non-invasive and painless technique that can help doctors diagnose disorders affecting the parathyroid glands, such as hyperparathyroidism or the presence of parathyroid adenomas. Thyroid ultrasound with possible elastosonography. In combination with each other, traditional thyroid ultrasound and elastosonography provide a complete view of the thyroid gland, allowing doctors to make more accurate evaluations and guide clinical choices for patients with thyroid pathologies. This happens by measuring the stiffness or elasticity of thyroid tissues, helping to distinguish between normal tissues and possible pathological areas such as suspicious nodules and, simultaneously, quantifying the size, shape, and structure and any presence of anomalies at the thyroid level. Monitoring thyroid function is fundamental because this gland plays a crucial role in regulating metabolism, energy, and hormonal balance in the body. Changes in its activity can influence various aspects of health, including weight, energy, mood, and general body functioning. For this reason, detecting anomalies promptly, such as nodules or alterations in thyroid function, allows for early intervention and management of any problems, avoiding more serious complications.