A CASE STUDY OF PECULIAR SOFT-TISSUE AND BONY CHANGES IN ASSOCIATION WITH THYROID DISEASE

Abstract

A case of thyroid acropachy is described. The pertinent literature is reviewed and this case discussed in terms of the other reports. Thyroid acropachy refers to a peculiar periosteal proliferation of bone limited to the metacarpals, metatarsals and phalanges, associated with terminal phalangeal clubbing. The patient first showed these bony changes following radioactive iodine therapy for Graves' disease at a time when she was considered euthyroid. In association with the bony changes there was swelling of the soft tissues overlying the involved phalanges and also unusually marked swelling of the orbital soft tissues. The pathology of the bony and soft-tissue lesions is described; it is not compatible with a diagnosis of either systemic or localized myxedema. The anterior pituitary gland and its secretory products probably play an important etiologic role in this condition.