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Thyroid
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Introduction: Examination of Thyroid
 Thyroid disease, the second most prevalent endocrine disorder, occurs in 10 to 15% of the population over age 40. The overall prevalence of overt hypothyroidism is approximately 1 to 3%, rising as high as 10% in women. Most cases of hypothyroidism present after the age of 50. In the otherwise healthy elderly, the prevalence of hypothyroidism is estimated at 1 to 5%, with a reported incidence ranging from 1 to 17%. The annual incidence of overt hyperthyroidism is 0.05% to 0.1% in adults with 1/3 of the thyrotoxicosis cases in individuals > 60 years old. Both hypo- and hyperthyroidism are more frequent in women than men.
Examination of the thyroid is done to look at size of the thyroid as well as for nodules. In addition, associated signs and symptoms can help determine the probability of thyroid dysfunction.
- Inspection
- Palpation
- Size, consistency, and nodularity
Maneuvers for detecting goiter (an enlarged thyroid) are described in this module.
In addition, the technique for detecting delayed relaxation of the Achilles tendon reflex, a highly predictive associated sign, is described.
Associated Evaluation
Related history and physical examination findings are described. Important aspects of hypo- or hyperthyroidism are the presence or absence of specific history or physical exam as well as the number of these findings.
Evidence Base
Several studies have evaluated the above maneuvers for detection of thyroid dysfunction. This data can guide the examiner in making a clinical determination of whether or not goiter, hypothyroidism or hyperthyroidism is present.
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