Physical Examination and Physical Diagnosis and Clinical Diagnosis of Thyroid Disorder
Diagnosis is an end-of-assessment statement on condition of the human body and its part – whether normal or abnormal; if abnormal, what kind of abnormality is suspected.
Diagnoses are commonly labelled as clinical diagnosis, physical diagnosis, radiologic diagnosis, operative diagnosis, laboratory diagnosis, histopathologic diagnosis, etc. depending on how the diagnoses are derived at, more specifically, from what type of examinations and from what type of diagnostic procedures.
Clinical diagnosis means the diagnosis is derived from data from the history or interview (or what are usually known as symptoms) and data from physical examination (or what are usually known as signs).
Physical diagnosis means the diagnosis is derived from data from the physical examination.
Radiologic diagnosis means the diagnosis is derived from a radiologic examination.
Operative diagnosis means the diagnosis is derived from the intraoperative findings.
Laboratory diagnosis means the diagnosis is derived from a laboratory examination.
Histopathologic diagnosis means the diagnosis is derived from a microscopic examination of tissue specimen.
As mentioned, physical examination can lead to a physical diagnosis. Physical examination of the thyroid gland can lead to a diagnosis whether there is a thyroid disorder or not and if there is, what kind is suspected – disorders in thyroid function: hyperthyroidism or hypothyroidism; disorders in anatomical structure – malignant or non-malignant nodule/s or mass/es. One has just have to process the data obtained from the physical examination.
To be able to process the data intelligently with the aim of coming out with a physical diagnosis, first, one has to know the potential diseases affecting the thyroid gland (at least the common ones); second, the signs if present that are suggestive of a particular thyroid disease; and third, the diagnostic processes usually being used (pattern recognition and prevalence; diagnosis by exclusion; etc.)
The potential diseases affecting the thyroid gland can be categorized (for simple and practical purpose) into disorders in thyroid function and disorders in anatomical structure. Disorders in thyroid function are hyperthyroidism and hypothyroidism. Disorders in anatomical structure can present with diffuse enlargement or nodule formation. Those presenting with nodule/s or mass/es are usually either malignant or non-malignant. Those presenting with diffuse enlargement are usually benign condition such as hyperthyroidism, hypothyroidism, and diffuse colloid adenomatous goiter.
The common malignant thyroid nodule/s or mass/es are papillary carcinomas; follicular carcinomas; medullary carcinomas; and anaplastic carcinomas. The common non-malignant disorders presenting with nodule/s or mass/es are colloid cysts; colloid adenomatous nodules; multiple colloid adenomatous goiter; follicular adenomas; and thyroiditis (acute and chronic).
After knowing the potential diseases that may affect the thyroid gland, one must know their usual presentation in terms of sign data (if one is after physical diagnosis). It is recommended that one must know also the usual presentation in terms of symptom data as these are needed in the formulation of the clinical diagnosis.
See also the following: