thyroid acropachy

Thyroid acropachy is an unusual presentation of autoimmune thyroid disease, (~1% of patients with Graves disease). It can occur in hyperthyroid, euthyroid, hypothyroid, or even post-treatment patients. It is almost always associated with thyroid ophthalmopathy.

Epidemiology

The majority of patients are smokers.

Clinical presentation

Clinically, it presents with soft tissue swelling, finger clubbing, and periosteal reaction of the extremities.

Radiographic features

Plain radiograph

• hands and feet involvement
• tubular bones
• usually bilateral and symmetrical
• prominent smooth flowing periosteal reaction with new bone formation at the metacarpals and phalanges
• soft tissue swelling (especially lower limbs) may be present

Differential diagnosis

• hypertrophic pulmonary osteoarthropathy
• pachydermoperiostosis
• hypervitaminosis A
• chronic vascular insufficiency
• voriconazole induced periostitis

Siehe auch:

• hypertrophe Osteoarthropathie
• Morbus Basedow
• vitamin A intoxication
• hypertrophic pulmonary osteoathropathy

und weiter:

• Pierre-Marie-Bamberger-Krankheit
• smooth periosteal reaction
• Akropachie
• leukämische Daktylitis