Question:medium
What investigation should be done for a prostatic nodule in a 60 year old man?
What investigation should be done for a prostatic nodule in a 60 year old man?
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Think about which test both images the prostate closely and can guide a biopsy needle.
Updated On: Jul 8, 2026
- Expressed prostatic secretion analysis
- CT scan pelvis
- Transrectal ultrasound (TRUS)
- MRI
Show Solution
The Correct Option is C
Solution and Explanation
Step 1: Understanding the Concept:
A prostatic nodule on rectal exam in a man of 60 needs a test that can look at the nodule closely and also help take a sample from it.
Step 2: Key Formula or Approach:
The rule with prostate nodules is to use the probe that sits nearest the gland, since a closer probe gives a sharper picture and an easier path for a biopsy needle.
Step 3: Detailed Explanation:
Transrectal ultrasound (TRUS) puts a small probe into the rectum, right behind the prostate. This gives a close, detailed view of the gland and any nodule in it.
Because the probe sits so close, TRUS also lets the doctor pass a biopsy needle straight into the nodule under direct vision, combining imaging and tissue sampling in one visit.
Expressed prostatic secretion testing checks for white cells and bacteria, which is a test for prostatitis, not cancer.
A CT scan of the pelvis looks at organs from outside the body and cannot separate the zones of the prostate well enough to find a small nodule.
MRI gives a detailed picture too and is useful once a cancer is already found, mainly to check how far it has spread, but it is not the standard first test for a fresh nodule, and it does not replace the biopsy step.
Step 4: Final Answer:
Transrectal ultrasound is the investigation of choice for a prostatic nodule, since it both shows the nodule and guides the needle biopsy.
\[ \boxed{\text{Transrectal ultrasound (TRUS)}} \]
A prostatic nodule on rectal exam in a man of 60 needs a test that can look at the nodule closely and also help take a sample from it.
Step 2: Key Formula or Approach:
The rule with prostate nodules is to use the probe that sits nearest the gland, since a closer probe gives a sharper picture and an easier path for a biopsy needle.
Step 3: Detailed Explanation:
Transrectal ultrasound (TRUS) puts a small probe into the rectum, right behind the prostate. This gives a close, detailed view of the gland and any nodule in it.
Because the probe sits so close, TRUS also lets the doctor pass a biopsy needle straight into the nodule under direct vision, combining imaging and tissue sampling in one visit.
Expressed prostatic secretion testing checks for white cells and bacteria, which is a test for prostatitis, not cancer.
A CT scan of the pelvis looks at organs from outside the body and cannot separate the zones of the prostate well enough to find a small nodule.
MRI gives a detailed picture too and is useful once a cancer is already found, mainly to check how far it has spread, but it is not the standard first test for a fresh nodule, and it does not replace the biopsy step.
Step 4: Final Answer:
Transrectal ultrasound is the investigation of choice for a prostatic nodule, since it both shows the nodule and guides the needle biopsy.
\[ \boxed{\text{Transrectal ultrasound (TRUS)}} \]
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