When examining the patient, look out for:
- Fidgety, sweaty, restless behaviour
- Tremor
- Bulging eyes
- Asymmetry of the neck, goitre
- How the thyroid looks from the front and the side, including whilst swallowing, to elicit the typical rise and fall of thyroid lumps (Fig 1)
Also:
- Palpate thyroid, from behind, +/- swallowing
- Percuss for retrosternal goitre
- Listen for thyroid bruit
Other relevant signs include:
- Occasional lymphadenopathy
- Tachycardia ( +/- atrial fibrillation) and wide pulse pressure
- Hyperreflexia
Fig 1 Observe how the thyroid swelling rises and falls as the patient drinks