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In most cases of hyperthyroidism, no imaging is necessary, since lab tests will usually be sufficient to make the diagnosis. Thyroid radio-iodine scanning is useful to determine whether an increase in thyroid hormone levels are coming from the whole gland, or from one or more hyperfunctioning nodules. Such nodules may be palpable on physical exam, but they may not be evident if they are small.
Nuclear medicine scanning also gives numeric data on iodine uptake, but does involve radiation, particularly to the thyroid gland itself, which should always be kept in mind before ordering any imaging study.
If there is any question of whether the gland is normal on physical exam, thyroid ultrasound can be considered, since it does not involve radiation and can give a detailed view of the size and shape of the gland, and is very sensitive for detection of nodules.
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