Goiter physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Physical examination of patients with Goiter is usually remarkable for swelling at the base of the neck.
Physical Examination
- Physical examination of patients with Goiter is usually remarkable for swelling at the base of the neck
Appearance of the Patient
- Patients with Goiter usually appear with a cosmetic distortion of the neck along with a lump at the base of the neck and are asymptomatic in general.
Vital Signs
Skin
- Moist skin
HEENT
- Exophthalmosis
Neck
- Jugular vein compression or thrombosis (Rare) [1]
- Superior vena cava syndrome (Rare) [1]
Lungs
- Normal vesicular breath sounds
- Wheeze may be present as a result of compression of the gland over the trachea
- Tracheal deviation or compression may be seen in some cases
- Stridor may be seen in some cases
Heart
- Normal S1 and S2.
Abdomen
- Normal abdominal findings.
Back
- Normal findings observed
Genitourinary
- Normal findings observed
Neuromuscular
Extremities
- Normal findings observed
Pemberton's sign
- While clinically evaluating an enlarged thyroid gland, pemberton's sign is observed. [2] [2] [3]
- Pemberton's sign is observed when both arms are elevated until the arms align with the side of the head. Usually in a minute of doing so, this elicits:
- Congestion of face
- Cyanosis
- Distress
- Vascular engorgement and facial congestion imply the impaired venous outflow from the head and neck
- Tracheal compromise may also be observed
- Venous thrombosis has also been seen in few cases
References
- ↑ 1.0 1.1 Siderys H, Rowe GA (1970). "Superior vena caval syndrome caused by intrathoracic goiter". Am Surg. 36 (7): 446–50. PMID 4913941.
- ↑ 2.0 2.1 De Filippis EA, Sabet A, Sun MR, Garber JR (2014). "Pemberton's sign: explained nearly 70 years later". J Clin Endocrinol Metab. 99 (6): 1949–54. doi:10.1210/jc.2013-4240. PMID 24646105.
- ↑ Basaria S, Salvatori R (2004). "Images in clinical medicine. Pemberton's sign". N Engl J Med. 350 (13): 1338. doi:10.1056/NEJMicm990287. PMID 15044645.