Odynophagia and globus sensation are common symptoms and the differential diagnosis can be extensive, including inflammatory, infectious, neoplastic, autoimmune and traumatic causes. Odynophagia and globus sensation are infrequently due to an underlying neck mass, and if so, the underlying lesion is usually quite apparent on physical examination. Neck or thyroid ultrasonography ordered to investigate patients with odynophagia and globus sensation are more likely to detect other entities such as benign thyroid nodules, rather than confirming a diagnosis that explains the patient’s symptoms and can lead to a cascade of other unnecessary tests that can be harmful to patients. Unfortunately, using tests to exclude conditions, can sometimes identify other diseases such as thyroid nodules, leading to further testing such as a FNA or repeat ultrasounds and in some cases treatment in the form of a thyroidectomy that may be unnecessary or harmful to patients.
Sources:
Hall SF, et al. Access, excess, and overdiagnosis: the case for thyroid cancer. Cancer Med. 2014 Feb;3(1):154-61. PMID: 24408145.
Hall SF, et al. Increasing detection and increasing incidence in thyroid cancer. World J Surg. 2009 Dec;33(12):2567-71. PMID: 19789911.