Clinical data: A 68-year-old woman was referred for evaluation of a recurrent thyroid nodule. She has been operated on for decades and had no documentation was available of the surgery.

Palpation: The right lobe was palpable but not nodular.

Laboratory test: TSH 1.94 mIU/L.

Ultrasonography. The right lobe was echonormal and had several discrete lesions including hypoechoic ones. The left lobe was decreased in size and had no discrete lesions of oncological significance.

Cytology performed from a hypoechoic nodule and resulted in benign colloid goiter.

Suggestion: ultrasound in two years.

Comment. It is worth analyzing the video records. The vascularization is deeply influenced by the movement of the surrounding organs. The most common confounding factor is the peristaltic movement of the esophagus which can be observed in the right lobe while an artifact caused by the pulsating carotid artery in the left lobe.