Examination
SPEG (Scottish Paediatric Endocrine Group)
Record the following findings:
Initial:
- Weight, height, growth velocity (if previous Ht available).
- Parents height if possible.
- Cardiovascular assessment including BP, pulseh
- Goitre exam, presence of bruit.
- Thyroid volume assessed clinically (consider measuring length of lobes with tape measure).
- Tremor, hyperkinesia.
- Eye exam - elicit lid lag.
- state if proptosis or not
- Range of eye movements - Pubertal Assessment.
- Skin.
Subsequent examinations during follow up:
- weight
- height
- growth velocity
- blood Pressure
- pulse
- goitre examination
- eye exam
- tremor.
Table 2: Prevalence of physical signs reported in BPSU survey (110 cases)
| Signs | Total | Graves' disease | Other cause of thyrotoxicosis |
| Goitre | 78.18% | 82.60% | 55.56% |
| Tremor | 58.18% | 60.90% | 44.44% |
| Lid retraction (staring eyes) | 31.82% | 37.00% | 5.56% |
| Exopthalmos/proptosis (forward displacement or bulging of the eye) | 29.09% | 32.60% | 11.11% |
| Thyroid bruit | 25.45% | 29.30% | 5.56% |
| Heart murmur | 7.27% | 6.50% | 11.11% |
| Diplopia | 1.82% | 2.20% | 0.00% |
| Myxoedema | 0.91% | 1.10% | 0.00% |
| Evidence of life threatening 'thyroid storm' (hyperthermia tachycardia, GI dysfunction, CNS dysfunction) | 0.00% | 0.00% | 0.00% |