Physical examination maneuver

Physical Exam

Thyroid Inspection

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How to Perform

With the patient seated and the neck neutral or slightly extended, inspect the lower anterior neck from the front and from the side. Identify the thyroid cartilage, the cricoid cartilage, and the region of the thyroid gland below the cricoid. Note the size, symmetry, and contour of the gland and any visible mass or enlargement.

How to Interpret

Showing 2 of 4 findings

Goiter

Visibly enlarged thyroid (goiter)
Rule in
HelpfulNo CI
Rule out
Somewhat helpfulNo CI
Evidence:Moderate

Thyroid Nodule

Visible thyroid nodule or focal anterior-neck mass moving with swallowing
Rule in
HelpfulDerived CI
Rule out
Minimally helpfulDerived CI
Evidence:Moderate

Related Bedside Tests

Thyroid PalpationMembers
Sign in
Thyroid Palpation
Rule in:VHThyroid Carcinoma, SHChronic Obstructive Pulmonary Disease, SHGoiter +4 more
Rule out:HThyroid Carcinoma, SHGoiter, MHChronic Obstructive Pulmonary Disease +4 more
Head and Neck Lymph Node PalpationMembers
Sign in
Head and Neck Lymph Node Palpation
Rule in:VHInfectious Mononucleosis, HMalignant Lymphadenopathy, SHThyroid Carcinoma +9 more
Rule out:SHMalignant Lymphadenopathy, MHInfectious Mononucleosis, ICConjunctivitis +9 more
Carotid Artery PalpationMembers
Sign in
Carotid Artery Palpation
Rule in:HAortic Stenosis, HTakayasu Arteritis, IEAcute Aortic Dissection +9 more
Rule out:SHAortic Stenosis, NHTakayasu Arteritis, IEAcute Aortic Dissection +9 more
Heart RateMembers
Sign in
Heart Rate
Rule in:SHAtrial Fibrillation, SHDecompensation, SHHypothyroidism +15 more
Rule out:HDecompensation, SHAtrial Fibrillation, SHPostoperative Complication +15 more
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Blood Pressure
Rule in:VHHypovolemia, VHMortality, VHStructural Brain Lesion +22 more
Rule out:VHCardiac Tamponade, VHHypovolemia, HLow Cardiac Output +22 more
Cardiac AuscultationMembers
Sign in
Cardiac Auscultation
Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy +37 more
Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy, VHRight-sided Valvular Lesion +37 more

Related Systems / Regions

EndocrineNeck

Related Diagnoses

GoiterThyroglossal Duct CystThyroid Nodule

Related Chief Complaints

AnxietyChoking SensationDiarrheaDifficulty SwallowingFacial SwellingFatigueHeat IntoleranceHoarse VoiceIncidental FindingNeck LumpNeck SwellingNoisy BreathingPalpitationsShortness of BreathSweatingTremorWeight Loss

References

  • Siminoski K. Does this patient have a goiter? JAMA. 1995;273(10):813-817. doi:10.1001/jama.1995.03520340069039. PMID: 7861577.
  • Setiawati R, Wulanhandarini T, Hayati F, Erawati D, Jaya MG, Thoriq AA, Wijaya TM, Ismiyati GN, Kusumaningrum DW, Koesmarsono B, Basja AT, Nugroho MI, Yuliana S, Shedyta SZ, Situmorang HB. Clinical and ultrasonography evaluation of thyroid tumor screening in symptomatic patient of Bajulmati primary care center, Banyuwangi, East Java, Indonesia. Medicine (Baltimore). 2022;101(52):e32546. doi:10.1097/MD.0000000000032546. PMID: 36596021. PMC9803475.
  • Girard M, DeLuca SA. Thyroglossal duct cyst. Am Fam Physician. 1990;42:665-668. PMID: 2392967.
  • Wallace C, Siminoski K. The Pemberton sign. Ann Intern Med. 1996;125(7):568-569. PMID: 8815756.
  • Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
  • Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab. 2008;22(6):901-911. doi:10.1016/j.beem.2008.09.019. PMID: 19041821.
  • Peterson S, Sanga A, Eklof H, Bunga B, Taube A, Gebre-Medhin M, Rosling H. Classification of thyroid size by palpation and ultrasonography in field surveys. Lancet. 2000;355(9198):106-110. doi:10.1016/S0140-6736(99)07221-9. PMID: 10675168.
  • Siminoski K. Does this patient have a goiter? JAMA. 1995;273(10):813-817. doi:10.1001/jama.1995.03520340069038. PMID: 7861577.
  • Soto Jacome C, Garcia A, Golembiewski E, Loor-Torres R, Duran M, Segura D, Toro-Tobon D, Fan JW, Singh Ospina N, Brito JP. Physical Examination of the Thyroid: Accuracy in Detecting Thyroid Nodules and Frequency of Additional Findings. Endocr Pract. 2024;30(1):31-35. doi:10.1016/j.eprac.2023.10.002. PMID: 37805101.
  • Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.
  • Wallace C, Siminoski K. The Pemberton sign. Ann Intern Med. 1996;125(7):568-569. doi:10.7326/0003-4819-125-7-199610010-00006. PMID: 8815756.

Research last updated September 10, 2026.