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


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
  • 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)

Differential diagnosis

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