The lost Art of Physical Examination of the Thyroid and Endocrine Neck

The lost Art of Physical Examination of the Thyroid and Endocrine Neck

The lost Art of Physical Examination of the Thyroid and  Endocrine Neck

The lost Art of Physical Examination of the Thyroid and Endocrine Neck

  1. Modern imaging and Thyroid function tests have resulted in few physicians in 2017 learn the proper way to examine a neck.
  2. Interview patient: Hoarsness, tracheal deviation, inspirational stridor, swallowing complaints, 3 D’s Dysphonia,dysphagia, dyspnea.
  3. Inspect the neck: scars, asymmetry, and masses. Lying down gives the best view of the neck and moves the thyroid gland up from a low neck position.
  4. Redness over a tender swelling + acute thyroiditis, infected thyroglossal duct or brancial cleft cyst.
  5.  Looking at the neck is a valuable tool to find thyroid disease. When swallowing the thyroid moves up 1.5 to 3.5 cm before moving back down.
  6. Pseudogoiter is seen in thin patients when the thyroid sits high in the neck.the gland is not enlarged and is normal.
  7. Long curved necks with cervical spine lordosis can have an illusion of a goiter. Painter Modigliani syndrome painted subjects with this illusion.
  8. Midline masses may be thyroglossal duct cysts which move up with extension of the tongue.
  9. Big goiters below the sternal notch can cause outlet obstruction and a vein extensions over the neck area. Pemberton’s sign.
  10. A normal thyroid is rarely palpated.
  11. A thrill can be felt and bruit heard over a thyrotoxic goiter.
  12. Palpation of the thyroid can cause temporary increase in T4, T3 and TG but not TSH.
  13. Extended palpation by several observers can cause palpation thyroiditis.
  14. Pain in the thyroid may indicate thyroiditis. Subacute thyroiditis has pain and tenderness. Rarely Hashimoto’s thyroiditis has pain. Acute pain is associated with a hemorrhage with a nodule. Cancer rarely has pain at onset.
  15. Neck lymph nodes and parathyroid cysts may be large enough to feel. Most are only found on ultrasound neck studies
  16. No just look at the ultrasound or blood studies. Take time to look and feel the neck structures.

 

9 Comments
  • reliablerxpharmacy.com coupon February 17, 2017 7:14 am

    Great goods from you, man. I have understand your stuff previous to and you’re just too
    wonderful. I actually like what you’ve acquired here, certainly like what you
    are saying and the way in which you say it. You make it enjoyable
    and you still take care of to keep it smart. I can not wait to read far more from you.

    This is really a tremendous web site.

  • 1stpharm legit February 20, 2017 9:34 am

    I savor, cause I discovered exactly what I was looking for.
    You have ended my 4 day long hunt! God Bless you man. Have a
    great day. Bye

  • cheap-rx.com coupon February 21, 2017 4:07 am

    Normally I don’t read post on blogs, but I wish to say that this write-up very forced
    me to check out and do so! Your writing taste
    has been amazed me. Thank you, very nice article.

  • viabestbuy.com complaints February 23, 2017 6:41 am

    What i do not understood is in reality how you’re not
    really a lot more well-preferred than you may be now. You’re
    so intelligent. You know therefore significantly when it
    comes to this subject, produced me in my view imagine it from
    so many various angles. Its like women and men aren’t fascinated unless
    it is one thing to do with Lady gaga! Your own stuffs nice.
    At all times take care of it up!

  • privatepharmacy.net legit March 2, 2017 12:33 am

    Hi, just wanted to mention, I enjoyed this article.
    It was practical. Keep on posting!

  • reliablerxpharmacy.com coupon March 2, 2017 5:58 am

    My brother recommended I might like this web site.
    He was entirely right. This post truly made my day. You cann’t imagine simply how
    much time I had spent for this information! Thanks!

  • corburterilio March 3, 2017 11:21 am

    Thank you for sharing excellent informations. Your web-site is so cool. I’m impressed by the details that you have on this web site. It reveals how nicely you perceive this subject. Bookmarked this web page, will come back for more articles. You, my friend, ROCK! I found simply the info I already searched everywhere and just could not come across. What an ideal web site.

  • corburterilio March 12, 2017 1:09 pm

    Hiya very cool website!! Guy .. Excellent .. Amazing .. I will bookmark your website and take the feeds additionallyKI am happy to seek out numerous useful info right here within the publish, we want work out extra strategies in this regard, thank you for sharing. . . . . .

  • click resources April 11, 2017 9:23 am

    I simply want to tell you that I am just very new to blogging and truly loved your page. Probably I’m want to bookmark your blog post . You actually have fantastic posts. Thanks a lot for sharing your blog site.

Add Your Comment

Contact Info
1328 16th Street, Santa Monica, CA 90404
Monday – Friday
9:00 AM to 5:00 PM
(310) 393-8860