Many thyroid-related disorders exhibit echogenic inhomogeneity of the thyroid gland parenchyma on ultrasound sonograms. The parenchyma of the thyroid gland is homogeneously isoechoic on ultrasound and can be seen as fine, dense dotted echogenicity. In a normal thyroid, the lobes are symmetrical, the echogenicity of the gland is homogeneous, and there are no abnormalities such as nodules or occupancies. In the absence of significant abnormalities in color Doppler flow imaging and blood flow spectra, the sonographer will indicate in the ultrasound diagnosis and cues that the thyroid gland is not significantly abnormal. When the thyroid gland is diffusely diseased or has thickened and enhanced echogenicity due to age, or when the parenchymal echogenicity of the gland is uneven, the ultrasonographer will usually indicate “uneven echogenicity of the thyroid gland or diffuse echogenicity of the thyroid gland (please combine with laboratory tests)” on the ultrasound report. This is usually seen in inflammatory thyroid conditions such as Hashimoto’s thyroiditis, subacute thyroiditis, or abnormal thyroid function such as hyperthyroidism or hypothyroidism. Therefore, the patient will be advised to have blood tests and thyroid function related tests. If the thyroid ultrasound is only suggestive of heterogeneous echogenicity of the gland or diffuse thyroid lesions, but the thyroid function is normal in laboratory tests, then treatment is usually not required and there is no need to worry too much, but regular observation is usually sufficient. Therefore, when the thyroid ultrasound report suggests inhomogeneous thyroid echogenicity or diffuse thyroid lesions, further examination of thyroid function is required before a comprehensive diagnosis is made.