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.
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The majority of patients are smokers.
Clinically, it presents with soft tissue swelling, finger clubbing and a 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 osteoarthropathy (HPOA)
- hypervitaminosis A
- chronic vascular insufficiency
Metabolic bone disease
- bone mineralisation
- pituitary gland-related
- thyroid gland-related
- osteosclerosis (differential diagnosis | mnemonic)
- thyroid inflammatory disease
- thyroid neoplasms
- thyroid nodules
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