NPTE Clinical Files

Shirley is a 48 year old female who has a past medical history of hypothyroidism. .She complains of difficulty performing all ADLs and states her stamina has decreased tremendously over the past six months upon examination.She has non-pitting edema, dry skin and poor peripheral circulation. Which of the following symptoms or signs would the PT find upon examination

A) Myxedema

B) Distal muscle weakness

C) Hyper Reflexia

D) Parasthesia in a glove stocking distribution

The PMH is important here, know in general that the thyroid is the “energy generator/ metabolism” so hypothyroidism would be shot to your energy levels. You are kind of down all the time. S/S are bradycardia, muscle weakness, dec. in stamina.

A) Myxedema- this is an increase of protein in the dermis, this attracts fluid which causes non-pitting edema

B) Distal muscle weakness- in hypothyroidism the key sign is PROXIMAL muscle weakness, this is because proximal muscle fibers convert from fast twitch to slow twitch

C) Hyper Reflexia- Remember hypothyroidism is an UNDER production, in general we are going to see decreased responses. This is more associated with a hyperthyroidism

D) Paranthesis in a glove stocking distribution- this more for DM neuropathy or Guillan Barre syndrome. You may have parasthsia but not in a glove stocking distribution.

***You could have CTS due to the myxedema pressing on the median nerve***

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