The grade of goiter is an important index to evaluate the severity of thyroid diseases and observe the therapeutic effect. According to the data of the World Health Organization, goiter is divided into the following five degrees.
0 degree: no goiter.
Grade ia: the thyroid gland is palpable, but it is still invisible when the neck is fully extended.
Class I b: When the neck is fully extended, the thyroid gland is palpable and visible.
ⅱ degree: thyroid gland can be seen in normal position.
ⅲ degree: the thyroid gland is obviously enlarged and can be seen at a certain distance.
Goiter, thyroid eye sign and localized myxedema are the three characteristic manifestations of hyperthyroidism patients. Clinically, about 90% patients with hyperthyroidism have different degrees of goiter, mostly diffuse symmetrical enlargement, which is smooth, soft, elastic and tenderness-free, and can move up and down with swallowing. There is no obvious relationship between the degree of swelling and the severity of the disease. Because the right lobe is larger than the left lobe under normal circumstances, some patients can also see asymmetric goiter.
Due to the expansion of thyroid blood vessels and the increase of blood flow, about 50% of patients can feel tremor, and 70% of patients can hear continuous vascular murmurs in the left and right lobes, and the systolic phase is obviously enhanced. The murmurs do not weaken or disappear with the head twisting from side to side, which is an important sign for the diagnosis of this disease.
It is normal to hear the buzzing of the neck vein and disappear or weaken when the head twists left and right.
A few thyroid glands located in the posterior mediastinum of sternum need isotope and X-ray examination to be diagnosed.