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%