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  • Overactive thyroid

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  • 242.20 Toxic multinodular goiter without mention of thyrotoxic crisis or storm
  • 242.90 Thyrotoxicosis without mention of goiter or other cause, and without mention of thyrotoxic crisis or storm
  • PT diagnosis codes that may be secondary to thyroid disorders
    • 315.4 Developmental coordination disorder
    • 709.2 Scar conditions and fibrosis of the skin
    • 719.70 Difficulty in walking involving joint site unspecified
    • 728.2 Muscular wasting and disuse atrophy, not elsewhere classified
    • 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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  • E05.20 Thyrotoxicosis with toxic multinodular goiter without thyrotoxic crisis or storm
  • E05.90 Thyrotoxicosis, unspecified without thyrotoxic crisis or storm

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Description

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Essentials of Diagnosis

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  • It is not the purview of a PT to medically diagnose hypothyroid but rather to recognize the possibility in the differential diagnosis process, especially when findings are not consistent with conditions commonly treated such as musculoskeletal, neuromuscular, integumentary, and cardiopulmonary
  • PTs may treat conditions caused by hyperthyroid or treat patients with hyperthyroid for other unrelated pathologies

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General Considerations

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  • May cause pathology in multiple organ systems
    • GI: liver
    • Cardiovascular: heart, peripheral circulation, blood pressure
  • Integumentary
  • May result in secondary problems
    • Aerobic capacity and muscle endurance impairment
    • Sarcopenia
    • Weakness/impaired muscle performance
    • Musculoskeletal problems
    • Neuromuscular problems
    • Weight gain, indicating the need for PT intervention depending on severity

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Demographics

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  • Higher incidence in women2
  • More difficult to diagnose in the elderly

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Signs and Symptoms

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  • Graves’ ophthalmopathy, red or swollen eyes, bulging or protruding eyeballs, impaired vision, inflammation, light sensitivity
  • Tachycardia
  • Cardiac: atrial fibrillation, arrhythmias, palpitations
  • Heart disease
  • Racing/rapid pulse
  • High blood pressure
  • Hyperactivity
  • Difficulty concentrating and focusing
  • Heat intolerance
  • Sweating, clammy skin
  • Confusion, disorientation
  • Diuresis
  • Weakness
  • Tremors
  • Neck pain
  • Unexplained weight loss with inability to gain weight
  • Difficulty swallowing
  • Change in voice
  • Fatigue2
  • Decreased activity tolerance
  • Sensitivity to cold
  • Dyspnea, shortness of breath
  • Airway obstruction
  • Enlarged thyroid
  • Increased appetite
  • Menstrual disturbance, irregularity2
  • Increased bowel frequency
  • Breast development in men
  • Clammy skin
  • Diarrhea
  • Hair loss
  • Hand tremor
  • Itching
  • Nausea and vomiting
  • Skin blushing or flushing
  • Difficulty sleeping
  • Osteoporosis

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Functional Implications

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  • Severe symptoms such as immediacy of need to urinate, increased volume of urine, and increase in bowel frequency may be disabling and result in inability or reluctance to leave home
  • Sarcopenia resulting in weakness, muscle mass loss, inability to ...

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