Thyroid Examination
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  • 6 Dec, 2020
  • Post author:Dr Tom Leach
  • Reading time:3 mins read
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Examining for the signs of thyroid disease is an important clinical skill. This examination encompasses a wide range of different parts of the body for the systemic signs of thyroid disease.



  • Wash Hands
  • Introduce yourself
  • Confirm the identity of the patient
  • Ask for the patient consent – explain what you are going to do, for example:
    • Today I’d like to examine you for signs of thyroid problems. This involve we feeling your neck, checking your pulse, checking your hands and checking your eyes… “

General Inspection

  • Signs of hyperthyroidism
    • Anxiety / agitations / restlessness
    • Sweaty
    • Bulging eyes (exophthalmost – aka proptosis)
  • Signs of hypothyroidism
    • Goitre (maybe obvious from across the room)
    • Appears cold (e.g. wearing extra layers of clothing)
    • Hair loss
    • Overweight
    • Dry skin



  • Tremor- best assessed by simply placing a piece of A4 paper rested across the back of outstretched hands – does the paper appear to vibrate or wiggle?
  • Palms
    • Erythema – suggests hyperthyroidism
    • Dry skin – suggests hypothyroidism


  • Temperature – warm or cool?
  • Clammy / sweaty?
  • Pulse – regular or irregular
    • AF is associated with hyperthyroidism
    • May be fast in hyperthyroidism
    • May be low in hypothyroidism



  • Dry skin, hair loss, dry brittle hair – hypothyroidism
  • Sweaty – hyperthyroidism
  • Eyes
    • Bulging eye – exophthalmos – hyperthyroidism
      • Check from the front and from the side
    • Eye movements
      • Ask the patient to follow your finger with their eyes, whilst keeping the head still. Start at the upper extremity of gaze and move downwards towards the lower extremity of gaze
      • Lid lag occurs when the upper eyelid does not follow the downward movement of the eye immediately and is instead perceptibly delayed, often in a jerky fashion



  • Any obvious swelling or mass?
  • Any scars (from previous surgery?)

Swallow Test

Observe for any movement of massess

Dr Tom Leach

Dr Tom Leach MBChB DCH EMCert(ACEM) FRACGP currently works as a GP and an Emergency Department CMO in Australia. He is also a Clinical Associate Lecturer at the Australian National University, and is studying for a Masters of Sports Medicine at the University of Queensland. After graduating from his medical degree at the University of Manchester in 2011, Tom completed his Foundation Training at Bolton Royal Hospital, before moving to Australia in 2013. He started almostadoctor whilst a third year medical student in 2009. Read full bio

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