"He never got over losing his job": death on the dole.

Findings on palpation are not always a guide to the true functional findings and the cause of hyperthyroidism. Our results supported this, with only 40 out of 63 cases being correctly diagnosed before the thyroid scan was obtained. Early diagnosis is particularly important in view of the excellent results achieved with radioiodine. Recent follow up studies (paper in preparation) of treatment of single hyperfunctioning nodules have shown that all patients could be rendered euthyroid, in most cases with only one dose of radioiodine, with no incidence of hypothyroidism in patients followed up for up to 10 years.3 We conclude that thyroid scanning is essential in the management of hyperthyroid patients who do not show the classical features of Graves' disease, especially when a nodule or a multinodular goitre is palpated and when no goitre is palpable. This would permit early and successful treatment of single and multiple hyperfunctioning nodules. We thank Susan Finer and Susan Ellam for database assistance and advice and Toni Buckley for typing the manuscript.