BACKGROUNDThe advancement of imaging in the diagnosis of thyroid nodules has led to increased detection and treatment of low-risk tumours. Therefore, it is important to assess the specificity and sensitivity of ultrasound as a means of initial staging to avoid further investigation of benign results. OBJECTIVESTo compare the results of ultrasound U staging with FNAC and histological staging and to analyse the sensitivity and specificity of ultraound U staging and FNAC. METHODSReview of 303 thryroidectomy cases between 2012-2017 at Walsall Manor Hospital, including radiologist review of scans and case review by a fourth year medical student and F1. RESULTSFor benign and malignant cases, the commonest ultrasound staging was U3 (figure 1). This requires further investigation. Ultrasound showed a high sensitivity but low specificity (table 1). CONCLUSION Patients are undergoing unnecessary surgery for benign conditions, and an inability for ultrasound to exclude benign conditions has been shown. Improvement in the initial investigation is therefore recommended.