Reasonabel Hypothesis SOP [1] | 9 of 2022 |
Balance of Probabilities SOP [2] | 10 of 2022 |
SOP Bulletin 228 [3]
Goitre is an enlargement of the thyroid gland.
Not all goitres are covered by this SOP:
Otherwise, goitre, including goitre associated with normal, increased or decreased thyroid function (i.e. euthyroid, hyperthyroid/toxic or hypothryroid goitre) is covered by this SOP.
The diagnosis is made on clinical grounds (finding an enlarged thyroid), or based on imaging evidence (e.g. thyroid ultrasound). To apply this SOP further evidence will be needed to indicate the absence of Hashimoto thyroiditis, Graves disease, malignant neoplasm of the thyroid gland and other excluded conditions.
Whether the goitre SOP, or the SOP for hypothyroidism, should be applied in cases where both an enlarged thyroid and decreased thyroid hormone function are present (and not due to one of the excluded conditions), will be a matter for judgement and medical advice. Generally in such cases both the goitre and the decreased thyroid hormone will have a single cause (or the goitre will be a consequence of the hypothyroidism) and a single diagnostic label and determination will be appropriate. The factors in the SOPs are nearly identical across the two SOPs so the choice of SOP will very rarely affect the outcome, but if it does, then the most beneficial SOP that is applicable should be used.
The relevant medical specialist is an endocrinologist.
* another SOP applies
# non-SOP condition
Most people with goitre have no symptoms (and normal thyoid function) and so the condition is first noticed at a medical examination or is found incidentally, e.g. after imaging performed for another reason. Some cases will present with symptoms of abnormal thyroid function and the goitre will be found in the investigation of those symptoms. In other cases the swelling in the neck may be noticed by the person or someone else.
Worsening would take the form of further enlargement of the thyroid, beyond the normal course of the condition. Treatment for goitre is variable. No active treatment may be required in some cases.
Links
[1] http://www.rma.gov.au/assets/SOP/2022/bd5790f388/009.pdf
[2] http://www.rma.gov.au/assets/SOP/2022/4b0fdeaa28/010.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20228.pdf