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Is it bilateral or unilateral? Bilateral exophthalmos would suggest hyperthyroidism. Unilateral exophthalmos suggests orbital tumor, abscess, or aneurysm.
If it is bilateral, are there signs of hyperthyroidism? If there are other ... DIAGNOSTIC WORKUP
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Is it focal or diffuse? Focal masses in the thyroid include thyroglossal cyst, toxic adenoma, colloid cyst, Riedel's struma, nontoxic adenoma, and malignancies.
Is there movement with protrusion of ... DIAGNOSTIC WORKUP
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Proptosis, or exophthalmos, may be caused by inflammatory, infectious, neoplastic, traumatic, or vascular etiologies. Thyroid-associated orbitopathy is by far the most common cause of proptosis. Some may have a benign course, but others follow a fulminant... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Proptosis is a finding that usually signals significant pathology. Regardless of duration of symptoms, a rapid evaluation is necessary to discover and treat malignancy or conditions that will result in visual loss.
Differential Diagnosis
... Workup and Diagnosis ... Treatment
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... The mnemonic VINDICATE is a useful and quick way to recall the causes of exophthalmos (for enophthalmos see the section on ptosis, page 441).
V—Vascular disorders include a carotid–cavernous fistula and cavernous sinus thrombosis.
I—
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Exophthalmos — the abnormal protrusion of one or both eyeballs — may result from hemorrhage, edema, or inflammation behind the eye; extraocular muscle relaxation; or space-occupying intraorbital lesions and metastatic tumors. This sign may occur suddenly or... History and physical examination ... Medical causes ... Special considerations ... History and physical examination ... ... Special considerations ... Pictures
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... An enlarged thyroid can result from inflammation, physiologic changes, iodine deficiency, thyroid tumors, and drugs. Depending on the medical cause, hyperfunction or hypofunction may occur with resulting excess or deficiency, respectively, of the hormone thyroxine.... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Thyroid Lesions
Adenoma (benign)
Atypical
Embryonal (trabecular)
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... Elevated Serum Thyroid-Stimulating Hormone
Primary hypothyroidism
Overt (low free T4)
Subclinical (normal free T4)
Assay problems ... Suppressed Serum Thyroid-Stimulating Hormone
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... Diffuse Goiter
Euthyroid or hypothyroid
Cigarette smoking (thiocyanate)
Increased intrinsic growth potential
... Multinodular Goiter ... Nongoiter Neck Masses ... References
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... Exophthalmos (also called proptosis) is the unilateral or bilateral bulging or protrusion of the eyeballs or their apparent forward displacement (with lid retraction). The prognosis depends on the underlying cause.
... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... The environment contains thousands of pathogenic microorganisms — viruses, bacteria, fungi, and parasites. Ordinarily, we protect ourselves from infectious organisms and other harmful invaders through an elaborate network of safeguards... Host defense system ... Antigens ... B lymphocytes ... T lymphocytes ... Macrophages ... Cytokines ... Complement system ... Polymorphonuclear leukocytes ... Immune disorders ... Hypersensitivity disorders ... Type I hypersensitivity (allergic disorders)
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... Non-Hodgkin's lymphomas, also known as malignant lymphomas and lymphosarcomas, are a heterogeneous group of malignant diseases originating in lymph glands and other lymphoid tissue. Nodular lymphomas have a better prognosis than the diffuse... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Inflammation of the thyroid gland occurs as autoimmune thyroiditis (long-term inflammatory disease), subacute granulomatous thyroiditis (self-limiting inflammation), Riedel’s thyroiditis (rare, invasive fibrotic process), and miscellaneous thyroiditis (acute... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Papillary and follicular carcinomas are the most common types of thyroid cancer and are usually associated with a longer survival. Papillary carcinoma accounts for half of all thyroid cancers in adults; it's most common in young adult females and metastasizes... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Simple (or nontoxic) goiter is a thyroid gland enlargement that isn’t caused by inflammation or a neoplasm, and is commonly classified as endemic or sporadic. Endemic goiter usually results from inadequate dietary intake of iodine associated with such factors as... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... An enlarged thyroid can result from inflammation, physiologic changes, iodine deficiency, and thyroid tumors. Depending on the medical cause, hyperfunction or hypofunction may occur with resulting excess or deficiency, respectively, of the hormone... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
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... Exophthalmos—the abnormal protrusion of one or both eyeballs—may result from hemorrhage, edema, or inflammation behind the eye; extraocular muscle relaxation; or space-occupying intraorbital lesions and metastatic tumors. This sign may occur suddenly or gradually,... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
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... Stephen F. Wheeler and David E. Bybee
Goiter, an enlarged thyroid gland, is the most common thyroid abnormality. Goiter is termed endemic if it occurs in more than 10% of a population. Endemic goiter most commonly... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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... Stephen F. Wheeler and David E. Bybee
Palpable nodules are present in 4% to 7% of adults. Prevalence is four to nine times greater in women than men. Approximately 5% of all solitary nodules are carcinomas.
Approach The evaluation... History ... Physical examination ... Testing ... Diagnostic assessment
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... Differential Overview
Neck Mass
❑ Inflammatory lymphadenopathy
❑ Parotid swelling/tumor
❑ Laryngeal cancer ... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Hashimoto thyroiditis
❑ Multinodular goiter
❑ Follicular adenoma
❑ Thyroid cyst ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
❑ Grave disease
❑ Familial
❑ Orbital asymmetry
❑ Orbital cellulitis ... Diagnostic Approach ... Clinical Findings
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... Inflammation of the thyroid gland occurs as autoimmune thyroiditis (long-term inflammatory disease), postpartum thyroiditis, subacute granulomatous thyroiditis (self-limiting inflammation), Riedel’s thyroiditis (rare, invasive fibrotic process), and miscellaneous thyroiditis... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Thyroid cancer occurs in all age groups, especially in persons who have had radiation treatment to the neck area. Papillary and follicular carcinomas are most common and are usually associated with prolonged survival.
... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Chronic fatigue and immune dysfunction syndrome (CFIDS) — also known as chronic fatigue syndrome, chronic Epstein-Barr virus [EBV], benign myalgic encephalomyelitis, and “Yuppie flu” — is typically marked by debilitating fatigue, neurologic... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Nontoxic or simple goiter — thyroid gland enlargement not caused by inflammation or a neoplasm — is commonly classified as endemic or sporadic.
Endemic goiter usually results from inadequate dietary intake of... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Exophthalmos — the abnormal protrusion of one or both eyeballs — may result from hemorrhage, edema, or inflammation behind the eye; extraocular muscle relaxation; or space-occupying intraorbital lesions and metastatic... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... An enlarged thyroid can result from inflammation, physiologic changes, iodine deficiency, and thyroid tumors. Depending on the medical cause, hyperfunction or hypofunction may occur with resulting excess or deficiency, respectively, of the hormone thyroxine. If no infection is... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... An enlarged thyroid can result from inflammation, physiologic changes, iodine deficiency, thyroid tumors, and drugs. Depending on the medical cause, hyperfunction or hypofunction may occur with resulting excess or deficiency, respectively, of the hormone thyroxine. If... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... Exophthalmos—the abnormal protrusion of one or both eyeballs—may result from hemorrhage, edema, or inflammation behind the eye; extraocular muscle relaxation; or space-occupying intraorbital lesions and metastatic tumors. This sign may occur suddenly or gradually,... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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The mnemonic VINDICATE is a useful and quick way to recall the
causes of exophthalmos (for enophthalmos, see the section on ptosis, page 369).
V—Vascular disorders include a carotid–cavernous... Pictures
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... Adda Grimberg, MD Goiter - BASICS Goiter - description Goiter is enlargement of the thyroid gland. Goiter - epidemiology The most common cause of pediatric goiter in the US is chronic lymphocytic ... Goiter - DIAGNOSIS ... Goiter - TREATMENT ... Goiter - FOLLOW UP ... Goiter - bibliography ... Goiter - CODES ... Goiter - FAQ
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While training for the Olympic games, track star Gail Devers began to suffer from a number of mysterious symptoms: weight loss, dry skin and fatigue....
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