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Thyroid acropachy

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

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 film
  • prominent solid or fluffy periosteal reaction affecting the hands and feet. It is usually bilateral and symmetrical involving the tubular bones of hands and feet. 
  • may also be evidence of soft tissue swelling (especially lower limbs)

Differential diagnosis

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