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.
The majority of patients are smokers.
Clinically, it presents with soft tissue swelling, finger clubbing and periosteal reaction of the extremities.
- 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)
- 1. Rana RS, Wu JS, Eisenberg RL. Periosteal reaction. AJR Am J Roentgenol. 2009;193 (4): W259-72. doi:10.2214/AJR.09.3300 - Pubmed citation
- 2. Fatourechi V, Ahmed DD, Schwartz KM. Thyroid acropachy: report of 40 patients treated at a single institution in a 26-year period. J. Clin. Endocrinol. Metab. 2003;87 (12): 5435-41. Pubmed citation
- 3. Scanlon GT, Clemett AR. THYROID ACROPACHY. Radiology. 1964;83 (6): 1039-42. Radiology (citation) - doi:10.1148/83.6.1039 - Pubmed citation
- 4. Parker LN, Wu SY, Lai MK et-al. The early diagnosis of atypical thyroid acropachy. Arch. Intern. Med. 1982;142 (9): 1749-51. Pubmed citation
- 5. Fatourechi V. Thyroid dermopathy and acropachy. Best Pract. Res. Clin. Endocrinol. Metab. 2012;26 (4): 553-65. doi:10.1016/j.beem.2011.10.001 - Pubmed citation
- 6. Batal O, Hatem SF. Radiologic case study. Thyroid acropachy. Orthopedics [Internet]. 2008 Jan [cited 2013 Nov 10];31(1):2, 98–100. Pubmed citation