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.[1][2][3]
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
Neck
- Jugular vein compression or thrombosis (rare) [4]
- Superior vena cava syndrome (rare) [4]
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.[5][6][7]
- 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
- ↑ Brandehoff N, Adams A, McDaniel K, Banister SD, Gerona R, Monte AA (2017). "Synthetic cannabinoid "Black Mamba" infidelity in patients presenting for emergency stabilization in Colorado: a P SCAN Cohort". Clin Toxicol (Phila): 1–6. doi:10.1080/15563650.2017.1357826. PMID 28862050.
- ↑ Bonnema SJ, Nielsen VE, Boel-Jørgensen H, Grupe P, Andersen PB, Bastholt L; et al. (2008). "Recombinant human thyrotropin-stimulated radioiodine therapy of large nodular goiters facilitates tracheal decompression and improves inspiration". J Clin Endocrinol Metab. 93 (10): 3981–4. doi:10.1210/jc.2008-0485. PMID 18664541.
- ↑ Jukić T, Kusić Z (2010). "Image in endocrinology. Pemberton's sign in patient with substernal goiter". J Clin Endocrinol Metab. 95 (9): 4175. doi:10.1210/jc.2010-0944. PMID 20823469.
- ↑ 4.0 4.1 Siderys H, Rowe GA (1970). "Superior vena caval syndrome caused by intrathoracic goiter". Am Surg. 36 (7): 446–50. PMID 4913941.
- ↑ 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.
- ↑ Anders H, Keller C (1997). "Pemberton's maneuver - a clinical test for latent superior vena cava syndrome caused by a substernal mass". Eur J Med Res. 2 (11): 488–90. PMID 9385120.