Toxic multinodular goitre Toxic multinodular goitre Toxic multinodular goiter (also known as toxic nodular goiter, or Plummer's disease) is an active multinodular goiter associated with hyperthyroidism. It is a common cause of hyperthyroidism in which there is excess production of thyroid hormones from functionally autonomous thyroid nodules, which do not require stimulation from thyroid stimulating hormone (TSH). Toxic multinodular goiter is the second most common cause of hyperthyroidism (after Graves' disease) in the developed world, whereas iodine deficiency is the most common cause of hypothyroidism in developing-world countries where the population is iodine-deficient. (Decreased iodine leads to decreased thyroid hormone.) However, iodine deficiency
Pseudo-goitre attached to the thyroid such as a true goitre, also moves along with thyroid. A pseudogoitre is unlikely if the area of fullness moves with swallowing. If pseudogoitre is due to cervical lordosis, the fullness disappears on straightening of the neck. A high-lying thyroid can be excluded by palpation. If the diagnosis is uncertain after clinical examination, an ultrasonogram is taken to rule out pathology of the neck. Pseudo-goitre Pseudo-goitre is the apparent fullness of the front part of the neck. It may be mistakenly diagnosed as thyroid enlargement. The cause for pseudogoitre can be fat tissue of the neck,