Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Chronic lymphocytic thyroiditisAutoimmune thyroiditis ++ 244.0 Postsurgical hypothyroidism244.1 Other postablative hypothyroidism244.2 Iodine hypothyroidism244.3 Other iatrogenic hypothyroidism244.8 Other specified acquired hypothyroidism244.9 Unspecified acquired hypothyroidism245.0 Acute thyroiditis245.2 Chronic lymphocytic thyroiditisAssociated ICD-9-CM PT diagnoses/treatment diagnoses that may be directly related315.4 Developmental coordination disorder718.45 Contracture of joint of pelvic region and thigh719.70 Difficulty in walking involving joint site unspecified728.2 Muscular wasting and disuse atrophy, not elsewhere specified728.89 Other disorders of muscle, ligament, and fascia729.9 Other and unspecified disorders of soft tissue780.7 Malaise and fatigue781.2 Abnormality of gait782.3 Edema786.0 Dyspnea and respiratory abnormalities786.05 Shortness of breath ++ E06.0 Acute thyroiditisE06.3 Autoimmune thyroiditisE89.0 Post-procedural hypothyroidism ++ 4E: Impaired joint mobility, motor function, muscle performance, and range of motion associated with localized inflammation6A: Primary prevention/risk reduction for cardiovascular/pulmonary disorders6B: Impaired aerobic capacity/endurance associated with deconditioning +++ Description ++ Autoimmune diseaseThyroid gland is gradually destroyedResults in hypothyroidismEnlargement of the thyroid +++ Essentials of Diagnosis ++ Thyroid gland becomes lobulatedDecreased activity toleranceSensitivity to coldAbnormal thyroid function testsOften misdiagnosed as fibromyalgia and depression +++ General Considerations ++ Diagnosis for more occult problems may take time and require intensive medical diagnostic testingMay cause pathology in multiple organ systemsCardiovascular: heart, peripheral circulation, blood pressureIntegumentaryMay result in secondary problems indicating the need for PT intervention depending on severityAerobic capacity and muscle endurance impairmentSarcopeniaWeakness/impaired muscle performanceMusculoskeletal problemsNeuromuscular problemsWeight gain, indicating the need for physical therapy intervention depending on severityGradual onsetHyperlipidemia +++ Demographics ++ Can occur in anyoneHigher incidence in women, primarily middle agedTends to run in familiesBetween 0.1% and 5% of all adults +++ Signs and Symptoms ++ Asymptomatic in some casesClinical findings for hypothyroidismConstipationHair lossFatigueWeight gainSlowed heart rateDry skinDepressionInfertilityGoiterPanic attacksMemory lossJoint stiffnessFacial swelling (lion mask) +++ Functional Implications ++ Severe symptoms such as immediacy of need to urinate may be disabling, resulting in the inability to leave homeInability to afford testing and medicationsFatigueDrowsinessInfertilityMiscarriageHeart diseaseDecreased sex driveIncreasing weight with inability to exercise or move wellSarcopenia resulting inWeaknessMuscle mass lossInability to ambulate or perform self-careAerobic capacity limitation secondary to inactivityDecreased exercise toleranceSleep disturbancesChanges in lifestyleEating disordersAnxiety and depressionCan lead to problems with liverLimitations in ADLs or IADLsSystemic infectionSkin lesions from drynessNeuropathy, increased risk for fallsVision impairment, most often retinalProne to infections such as bacterial in the skin, fungal, urinary tract infections (UTIs), kidneyPotential for ... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.