Thyroid acropachy

Case contributed by Yi-Jin Kuok
Diagnosis certain

Presentation

Hand swelling and finger clubbing.

Patient Data

Age: 55 years
Gender: Female
x-ray

Prominent solid periosteal reaction affecting phalanges and distal of radius and ulna. There is also evidence of soft tissue swelling.

Case Discussion

The findings in a 55 year old patient with hyperthyroidism are compatible with thyroid acropachy.

Thyroid acropachy is an uncommon manifestation of autoimmune thyroid disease which presented with digital clubbing, swelling of digits and toes, and periosteal reaction of extremity bones. The term acropachy is a Greek word for thickening of the extremities. It is almost always associated with thyroid ophthalmopathy and dermopathy.

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