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.
The majority of patients are smokers.
Clinically, it presents with soft tissue swelling, finger clubbing and periosteal reaction of the extremities.
- prominent smooth flowing 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)
- hypertrophic pulmonary osteoathropathy (HPOA)
- hypervitaminosis A
- chronic vascular insufficiency
Metabolic bone disease
- bone mineralisation
- pituitary gland-related
- thyroid gland-related
- osteosclerosis (differential diagnosis | mnemonic)
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