Goiter physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Reddy Kothagadi M.B.B.S[2]

Physical examination of patients with goiter is usually remarkable for swelling at the base of the neck.

Physical examination of patients with goiter is usually remarkable for swelling at the base of the neck.^[1][2]

• 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.

• Tachycardia

• Moist skin

• Exophthalmos

• Jugular vein compression or thrombosis (rare) ^[3]
• Superior vena cava syndrome (rare) ^[3]

• Normal vesicular breath sounds
• Wheeze may be present as a result of compression of the thyroid gland over the trachea
• Tracheal deviation or compression may be seen in some cases
• Stridor may be seen in some cases

• Normal S1 and S2
• No rubs or gallop

• Normal abdominal findings

• Normal findings observed

• Normal findings observed

• Tremors

• Normal findings observed

• While clinically evaluating an enlarged thyroid gland, Pemberton’s sign is observed.^[4][5][6]
• 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 compression may also be observed
• Venous thrombosis has also been seen in few cases

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