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Condition/Disorder Synonyms

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  • Chronic lymphocytic thyroiditis

  • Autoimmune thyroiditis

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ICD-9-CM Codes

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  • 244.0 Postsurgical hypothyroidism

  • 244.1 Other postablative hypothyroidism

  • 244.2 Iodine hypothyroidism

  • 244.3 Other iatrogenic hypothyroidism

  • 244.8 Other specified acquired hypothyroidism

  • 244.9 Unspecified acquired hypothyroidism

  • 245.0 Acute thyroiditis

  • 245.2 Chronic lymphocytic thyroiditis

  • Associated ICD-9-CM PT diagnoses/treatment diagnoses that may be directly related

    • 315.4 Developmental coordination disorder

    • 718.45 Contracture of joint of pelvic region and thigh

    • 719.70 Difficulty in walking involving joint site unspecified

    • 728.2 Muscular wasting and disuse atrophy, not elsewhere specified

    • 728.89 Other disorders of muscle, ligament, and fascia

    • 729.9 Other and unspecified disorders of soft tissue

    • 780.7 Malaise and fatigue

    • 781.2 Abnormality of gait

    • 782.3 Edema

    • 786.0 Dyspnea and respiratory abnormalities

    • 786.05 Shortness of breath

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ICD-10-CM Codes

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  • E06.0 Acute thyroiditis

  • E06.3 Autoimmune thyroiditis

  • E89.0 Post-procedural hypothyroidism

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Preferred Practice Patterns1

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Key Features

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Description

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  • Autoimmune disease

  • Thyroid gland is gradually destroyed

  • Results in hypothyroidism

  • Enlargement of the thyroid

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Essentials of Diagnosis

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  • Thyroid gland becomes lobulated

  • Decreased activity tolerance

  • Sensitivity to cold

  • Abnormal thyroid function tests

  • Often misdiagnosed as fibromyalgia and depression

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General Considerations

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  • Diagnosis for more occult problems may take time and require intensive medical diagnostic testing

  • May cause pathology in multiple organ systems

    • Cardiovascular: heart, peripheral circulation, blood pressure

    • Integumentary

  • May result in secondary problems indicating the need for PT intervention depending on severity

    • Aerobic capacity and muscle endurance impairment

    • Sarcopenia

    • Weakness/impaired muscle performance

    • Musculoskeletal problems

    • Neuromuscular problems

    • Weight gain, indicating the need for physical therapy intervention depending on severity

  • Gradual onset

  • Hyperlipidemia

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Demographics

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  • Can occur in anyone

  • Higher incidence in women, primarily middle aged

  • Tends to run in families

  • Between 0.1% and 5% of all adults

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Clinical Findings

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Signs and Symptoms

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  • Asymptomatic in some cases

  • Clinical findings for hypothyroidism

  • Constipation

  • Hair loss

  • Fatigue

  • Weight gain

  • Slowed heart rate

  • Dry skin

  • Depression

  • Infertility

  • Goiter

  • Panic attacks

  • Memory loss

  • Joint stiffness

  • Facial swelling (lion mask)

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Functional Implications

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  • Severe symptoms such as immediacy of need to urinate may be disabling, resulting in the inability to leave home

  • Inability to afford testing and medications

  • Fatigue

  • Drowsiness

  • Infertility

  • Miscarriage

  • Heart disease

  • Decreased sex drive

  • Increasing weight with inability to exercise or move well

  • Sarcopenia resulting in

    • Weakness

    • Muscle mass loss

    • Inability to ambulate or perform self-care

    • Aerobic capacity limitation secondary to inactivity

  • Decreased exercise tolerance

  • Sleep disturbances

  • Changes in lifestyle

  • Eating disorders

  • Anxiety and depression

  • Can lead to problems with liver

  • Limitations in ADLs or IADLs

  • Systemic ...

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