Goiter

• Enlarged thyroid

• 240.9 Goiter, unspecified
• 241.0 Nontoxic uninodular goiter
• 241.1 Nontoxic multinodular goiter
• 241.9 Unspecified nontoxic nodular goiter
• 242 Thyrotoxicosis with or without goiter
• 242.0 Toxic diffuse goiter
• 242.00 Toxic diffuse goiter without mention of thyrotoxic crisis or storm
• 242.01 Toxic diffuse goiter with mention of thyrotoxic crisis or storm
• 242.1 Toxic uninodular goiter
• 242.10 Toxic uninodular goiter without mention of thyrotoxic crisis or storm
• 242.11 Toxic uninodular goiter with mention of thyrotoxic crisis or storm
• 242.2 Toxic multinodular goiter
• 242.20 Toxic multinodular goiter without mention of thyrotoxic crisis or storm
• 242.21 Toxic multinodular goiter with mention of thyrotoxic crisis or storm
• 242.3 Toxic nodular goiter unspecified type
• 242.30 Toxic nodular goiter, unspecified type, without mention of thyrotoxic crisis or storm
• 242.31 Toxic nodular goiter, unspecified type, with mention of thyrotoxic crisis or storm
• 242.40 Thyrotoxicosis from ectopic thyroid nodule without mention of thyrotoxic crisis or storm

• E01.1 Iodine-deficiency related multinodular (endemic) goiter
• E01.2 Iodine-deficiency related (endemic) goiter, unspecified
• E03.0 Congenital hypothyroidism with diffuse goiter
• E03.1 Congenital hypothyroidism without goiter
• E04 Other nontoxic goiter
• E04.0 Nontoxic diffuse goiter
• E04.2 Nontoxic multinodular goiter
• E04.8 Other specified nontoxic goiter
• E04.9 Nontoxic goiter, unspecified
• E05.00 Thyrotoxicosis with diffuse goiter without thyrotoxic crisis or storm
• E05.0 Thyrotoxicosis with diffuse goiter
• E05.2 Thyrotoxicosis with toxic multinodular goiter
• E07.1 Dyshormogenetic goiter
• P72.0 Neonatal goiter, not elsewhere classified

• 4E: Impaired joint mobility, motor function, muscle performance, and range of motion associated with localized inflammation1
• 6A: Primary prevention/risk reduction for cardiovascular/pulmonary disorders2
• 6B: Impaired aerobic capacity/endurance associated with deconditioning3

Description

• Enlarged thyroid gland, can result in decreased production of thyroid hormone
• Prolonged elevation of thyroid stimulating hormone (TSH)
• Weight gain or loss
• May range from single or small nodules to significant enlargement
• Multinodular goiter4
• Enlargement can limit neck mobility and swallowing

Essentials of Diagnosis

• Fatigue
• Decreased activity tolerance
• Sensitivity to cold
• Abnormal thyroid function tests
• Thyroid enlargment

General Considerations

• Diagnosis for more occult problems may take time and require intensive diagnostic testing, inability to afford testing and medications, noncompliance with medication regimen
• May cause pathology in multiple organ systems
  • GI: liver
  • Cardiovascular: heart, peripheral circulation, blood pressure
  • Integumentary
• May result in secondary problems indicating need for PT intervention: aerobic capacity and muscle endurance impairment, sarcopenia, weakness, musculoskeletal problems, neuromuscular problems, weight gain
• Hyperlipidemia
• Can result in hyperthyroid

Demographics

• Can occur in anyone throughout lifespan, beginning at birth (1 in 4,000 infants affected)
• Estimated 5 million people affected in the U.S., and an equal number undiagnosed
• Higher incidence in women and people aged 60 years and older

Signs and Symptoms

• Nausea
• Vomiting
• Diarrhea
• Coughing
• Sweating
• Shaking agitation
• Hoarseness
• Dizziness with arms overhead
• Difficulty swallowing
• Sensitivity to cold
• Slowed or rapid heart rate
• Constipation
...