A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; further:
- Inspection (viewing).
- Skin, mucous membranes, and the sclera (white part of the eye) [Leading symptoms: enophthalmos (retraction of the eyeball); miosis (pupillary constriction); ptosis (drooping of the eyelid)]
- Jaw [accompanying symptom: pain in the area of the jaw angle]
- Inspection and palpation (palpation) of the neck region (thyroid region) [leading symptoms: coarse but indolent (painless) nodes on the neck that rapidly increase in size, as well as nodes fused to the substrate or with signs of environmental infiltration (→ Horner’s syndrome, recurrent paresis) [due todifferential diagnoses:
- Focal thyroiditis (inflammation of the thyroid gland).
- Struma nodosa (nodular goiter)
- Thyroiditis (inflammation of the thyroid gland)]
- Palpation of lymph node stations (cervical, axillary, supraclavicular, inguinal) [leading symptom: lymph node enlargement]
- Palpation of the neck region [pain in the neck region.]
- Inspection and palpation of the spine
- Auscultation (listening) of the heart
- Auscultation of the lungs
- Palpation of the abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, kidney bearing knocking pain?)
- Inspection (viewing).
- Health check (as an additional follow-up).
Square brackets [ ] indicate possible pathological (pathological) physical findings.