Thyroid ultrasound is a fundamental test in the diagnosis of thyroid pathologies; its use, however, must take place in an appropriate clinical setting. Small thyroid nodules are very common in the general population and, in most cases, benign. Furthermore, in the last decades, there has been a notable increase in the diagnosis of thyroid carcinoma (often differentiated and small in size), not associated with an increase in mortality, thus highlighting a condition of overdiagnosis. The indiscriminate execution of ultrasound not only identifies a large number of thyroid nodules devoid of “pathological weight” but can cause anxiety in the patient and an increase in diagnostic procedures and surgical interventions (possible overtreatment), with consequent unjustified costs for the community, as well as possible harm to the patient. It is therefore recommended 1) to avoid ultrasound screening on populations not at risk for thyroid cancer; 2) avoid frequent ultrasound checks in subjects with chronic autoimmune thyroiditis and without nodules; 3) limit the indication and execution of fine needle aspirations on nodules which, based on the stratification of the risk of malignancy on ultrasound, belong to the low-risk classes.

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