Postpartum thyroiditis physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sunny Kumar MD [2]

Overview

The presence of signs of hyperthyroidism or hypothyroidism in postpartum period on physical examination is highly suggestive of PPT.

Physical Examination

The presence of signs of hyperthyroidism or hypothyroidism in postpartum period on physical examination is highly suggestive of PPT. ^[1] ^[2]

Appearance of the Patient

Patients with PPT usually appear tired or irritable depend of the phase of disease.


Systems involved	Hyperthyroidism	Hypothyroidism

Vital Signs	Low-grade fever Tachycardia with regular pulse or irregular pulse Tachypnea High blood pressure	Bradycardia with regular pulse Low blood pressure
Skin	Sweating increased Onycholysis Hyperpigmentation Pruritus and hives Vitiligo and alopecia areata Thinning of the hair Pretibial myxedema in co-existing Grave’s disease	Sweating decreased Dry skin Hair coarse and brttile Brittle nails Non-pitting edema
HEENT	Stare and lid lag Proptosis Gritty sensation in eyes Lid lag	Icteric sclera Pallor
Abdomen	Abdominal distention in patients with constipation Abdominal tenderness in the right upper abdominal quadrant with autoimmune hepatitis Hepatomegaly or splenomegaly or hepatosplenomegaly Dull note on percussion in peritoneal effusion	Increased peristaltic movements in patients
Back	Point tenderness over lumbar vertebrae in osteoporosis Costovertebral angle tenderness bilaterally osteoporosis	Point tenderness over lumbar vertebrae in osteoporosis Costovertebral angle tenderness bilaterally osteoporosis
Genitourinary	Urinary frequency Menstrual irregularities	Menstrual irregularities
CNS	Hyperreflexia Proximal muscle weakness Unilateral or bilateral tremor Anxiety, restlessness, irritability, and emotional liability	Hyporeflexia Proximal muscle weakness low mood, depression Carpal tunnel syndrome
Extremities	Fasciculations Tremors in the upper and lower extremity	Clubbing in hypothyroid phase Non-pitting edema of the lower extremities in hypothyroid phase Muscle atrophy

References

↑ Stagnaro-Green A (2000). “Recognizing, understanding, and treating postpartum thyroiditis”. Endocrinol Metab Clin North Am. 29 (2): 417–30, ix. PMID 10874538.
↑ Stagnaro-Green A (2004). “Postpartum thyroiditis”. Best Pract Res Clin Endocrinol Metab. 18 (2): 303–16. doi:10.1016/j.beem.2004.03.008. PMID 15157842.

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[pmid10874538-1] Stagnaro-Green A (2000). “Recognizing, understanding, and treating postpartum thyroiditis”. Endocrinol Metab Clin North Am. 29 (2): 417–30, ix. PMID 10874538.

[pmid15157842-2] Stagnaro-Green A (2004). “Postpartum thyroiditis”. Best Pract Res Clin Endocrinol Metab. 18 (2): 303–16. doi:10.1016/j.beem.2004.03.008. PMID 15157842.

[1]

[2]

Postpartum thyroiditis physical examination

Overview

Physical Examination

Appearance of the Patient

References

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