A 55-year-old man presents with a puffy face, hoarse voice, and swollen hands. He also complains of muscle weakness and joint pain. On examination, his reflexes are delayed. What are the potential diagnoses, and what are the next steps?
The patient's symptoms of facial puffiness, hoarseness, swelling of the hands, muscle weakness, joint pain, and delayed reflexes could suggest hypothyroidism. Other potential causes include myopathy, arthritis, or a systemic autoimmune condition. The next step would be to confirm the diagnosis with serum TSH and free T4 levels.