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 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)
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Metabolic bone disease
- bone mineralisation
- osteosclerosis (differential diagnosis / mnemonic)
- pituitary gland-related
- thyroid gland-related
- thyroid inflammatory disease
- thyroid neoplasms
- thyroid nodules
- assessment of thyroid lesions
- postoperative assessment after thyroid cancer surgery
- ultrasound-guided fine needle aspiration of the thyroid