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24: GOITER

Debra F. Stern, DPT, DBA, MSM, PT; Eric Shamus, PhD, DPT, PT, CSCS; Wendy Song, DO

CONDITION/DISORDER SYNONYM

  • Enlarged thyroid

ICD-9-CM CODES

  • 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

ICD-10-CM CODES

  • 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

FIGURE 24-1

Goiter with hyperthyroidism symptoms: Patient has large solitary toxic adenoma on the left lobe. (From Tintinalli JE, Stapczynski JS, Ma JA, Cline DM, Cydulka RK, Meckler GD. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. 7th ed. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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FIGURE 24-2

Axial contrast-enhanced CT scan of the neck in an elderly woman with a gradually enlarging neck mass demonstrates massive enlargement of a heterogeneously enhancing thyroid gland (arrowheads). There is maintenance of a smooth margin; however, no evidence of any invasion of adjacent structures. No abnormal lymph nodes are identified. Adjacent structures are displaced and compressed by this large mass, notably, the trachea (Tr), esophagus (E), and carotid (C) and jugular (J) vessels. The surgical pathology confirmed diffuse goiter. (From Lalwani AK. Current Diagnosis & Treatment in Otolaryngology-Head & Neck Surgery. 3rd ed. www.accesssurgery.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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PREFERRED PRACTICE PATTERNS

  • 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

PATIENT PRESENTATION

A 35-year-old female presents with low back pain and fatigue from standing at work for 4 hours. The ...

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