Abstract
Endocrine disorders can lead to disturbances in numerous systems within the body,
including the musculoskeletal system. Radiological evaluation of these conditions
can demonstrate typical appearances of the bones and soft tissues. Knowledge of these
patterns can allow the radiologist to suggest a diagnosis that may not be clinically
apparent.
This review will highlight the typical musculoskeletal findings of acromegaly, hypercortisolism,
hyperthyroidism, hypothyroidism, hyperparathyroidism, pseudo- and pseudopseudohypoparathyroidism,
and diabetes mellitus. The radiological manifestations of each of these endocrine
disorders, along with a brief discussion of the pathophysiology and clinical implications,
will be discussed.
Keywords
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References
- Medical progress: acromegaly.N Engl J Med. 2006; 355: 2558-2573
- Diagnosis of bone and joint disorders.4th ed. Saunders, Philadelphia, PA2002
- Extrapituitary acromegaly.Endocrinol Metab Clin North Am. 1991; 20: 507-518
- Somatotroph hyperplasia: successful treatment of acromegaly by removal of a pancreatic islet tumor secreting a growth hormone-releasing factor.Trans Assoc Am Physicians. 1982; 95: 177-187
- Systemic complications of acromegaly: epidemiology, pathogenesis, and management.Endocr Rev. 2004; 25: 102-152
- Acromegaly.Radiology. 1959; 72: 535-549
- Musculoskeletal complications of acromegaly: what radiologists should know about early manifestations.Radiol Med. 2011; 116: 781-792
- Osteoarticular changes in acromegaly.Int J Endocrinol. 2012; 2012: 839282
- Measurement of the heel-pad as an aid to diagnosis of acromegaly.Radiology. 1964; 82: 418-423
- Fallibility of the heel-pad thickness in the diagnosis of acromegaly.Radiology. 1967; 88: 982-983
- Cushing's syndrome.N Engl J Med. 1995; 332: 791-803
- Ectopic ACTH syndrome: our experience with 25 cases.Eur J Endocrinol. 2006; 155: 725-733
- Cushing's disease: its roentgenographic findings.Radiology. 1956; 67: 17-25
- Bone demineralization and vertebral fractures in endogenous cortisol excess: role of disease etiology and gonadal status.J Clin Endocrinol Metab. 2006; 91: 1779-1784
- Cushing's syndrome and bone.Pituitary. 2004; 7: 249-252
- Avascular necrosis of bone in Cushing's syndrome.Radiology. 1964; 83: 1068-1070
- Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment.J Bone Joint Surg Br. 1985; 67: 3-9
- Avascular necrosis versus other diseases of the hip: sensitivity of MR imaging.Radiology. 1988; 169: 213-215
- The effect of thyroid hormone on skeletal integrity.Ann Intern Med. 1999; 130: 750-758
- Hyperthyroidism, thyroid hormone therapy, and bone.Thyroid. 1994; 4: 319-326
- Effect of hyperthyroidism and its treatment on bone mineral content.Arch Intern Med. 1985; 145: 883-886
- Musculoskeletal manifestations of thyroid disease.Bull Rheum Dis. 2000; 49: 1-3
- Musculoskeletal manifestations of thyroid disease.Rheum Dis Clin North Am. 2010; 36: 637-646
- Thyroid acropachy: an unusual rheumatic manifestation of Graves' disease.Clin Exp Rheumatol. 2005; 23: 125-126
- Radiologic case study. Thyroid acropachy.Orthopedics. 2008; 31 ([2]): 98-100
- Thyroid acropachy.Intern Med J. 2004; 34: 513-514
- Musculoskeletal manifestations in patients with thyroid disease.Clin Endocrinol. 2003; 59: 162-167
- Congenital hypothyroidism—correlation between radiographic appearances of the knee epiphyses and biochemical data.Postgrad Med J. 1991; 67: 553-556
- Radiological manifestations of juvenile hypothyroidism.Thyroid Res Pract. 2012; 9: 102-104
- Hyperparathyroid and hypoparathyroid disorders.N Engl J Med. 2000; 343: 1863-1875
- Clinical practice. Primary hyperparathyroidism.N Engl J Med. 2011; 365: 2389-2397
- Mechanisms of secondary hyperparathyroidism.Am J Physiol Renal Physiol. 2002; 283: F367-F376
- Secondary hyperparathyroidism: pathogenesis, disease progression, and therapeutic options.Clin J Am Soc Nephrol. 2011; 6: 913-921
- Evaluation and management of primary hyperparathyroidism.J Clin Endocrinol Metab. 1996; 81: 2036-2040
- Early radiographic manifestations of secondary hyperparathyroidism associated with chronic renal disease.Radiology. 1977; 125: 645-652
- Bone disease in primary hyperparathyrodism.Ther Adv Musculoskelet Dis. 2012; 4: 357-368
- Localized osteosclerosis in hyperparathyroidism.Radiology. 1962; 78: 955-958
- Subchondral resorption of bone in renal osteodystrophy.Radiology. 1976; 118: 315-321
- Primary hyperparathyroidism. A comprehensive study of clinical, biochemical and radiographic manifestations.Radiology. 1973; 109: 513-524
- The skull in hyperparathyroid bone disease.Am J Roentgenol Radium Ther Nucl Med. 1960; 83: 732-742
- A case of multiple brown tumors with primary hyperparathyroidism.J Bone Miner Metab. 2013; 31: 123-127
- Primary hyperparathyroidism having multiple Brown tumors mimicking malignancy.Indian J Endocrinol Metab. 2012; 16: 1040-1042
- Brown tumors mimicking bone metastases.J Natl Med Assoc. 2006; 98: 950-953
- Articular and fibrocartilage calcification in hyperparathyroidism: associated hyperuricemia.Radiology. 1964; 83: 468-471
- MRI visualization of bilateral quadriceps tendon rupture in a patient with secondary hyperparathyroidism: implications for diagnosis and therapy.Comput Med Imaging Graph. 1989; 13: 407-410
- Current concepts and management strategies in chronic kidney disease-mineral and bone disorder.South Med J. 2012; 105: 479-485
- Imaging of renal osteodystrophy.Eur J Radiol. 2003; 46: 85-95
- Mineral and bone disorders in chronic kidney disease: new insights into mechanism and management.Ann Clin Biochem. 2012; 49: 432-440
- Osteosclerosis in hyperparathyroidism.Radiology. 1972; 105: 265-275
- Renal osteodystrophy.N Engl J Med. 1995; 333: 166-175
- Development of renal bone disease.Eur J Clin Invest. 2006; 36: 2-12
- Primary hyperparathyroidism and the risk of fracture: a population-based study.J Bone Miner Res. 1999; 14: 1700-1707
- Evolution of bone disease over 10 years in 135 patients with terminal renal failure.Br Med J. 1973; 4: 315-319
- When man turns to stone: extraosseous calcification in uremic patients.Kidney Int. 2004; 65: 2447-2462
- Massive, painful tumoral calcinosis in a long-term hemodialysis patient.Hemodial Int. 2011; 15: 577-580
- Clinical review: pseudohypoparathyroidism: diagnosis and treatment.J Clin Endocrinol Metab. 2011; 96: 3020-3030
- GNAS epigenetic defects and pseudohypoparathyroidism: time for a new classification?.Horm Metab Res. 2012; 44: 716-723
- The GNAS locus and pseudohypoparathyroidism.Adv Exp Med Biol. 2008; 626: 27-40
- Genetics of hypoparathyroidism and pseudohypoparathyroidism.J Endocrinol Invest. 2011; 34: 27-34
- Pseudopseudohypoparathyroidism.Lancet. 2009; 374: 2090
- Pseudohypoparathyroidism, an often delayed diagnosis: a case series.Case J. 2009; 2: 6734
- Musculoskeletal manifestations of diabetes mellitus.Br J Surg. 2003; 37: 30-35
- Musculoskeletal disorders in diabetes mellitus.Rev Bras Reumatol. 2012; 52: 601-609
- Diabetic musculoskeletal complications and their imaging mimics.Radiographics. 2012; 32: 1959-1974
- Musculoskeletal manifestations of endocrine disorders.Curr Opin Rheumatol. 2005; 17: 64-69
- Radiographic abnormalities in the feet of patients with diabetic neuropathy.Diabetes Care. 1994; 17: 201-209
- Neuro-arthropathy (Charcot joints) in diabetes mellitus (clinical study of 101 cases).Medicine. 1972; 51: 191-210
- Assessment and management of foot disease in patients with diabetes.N Engl J Med. 1994; 331: 854-860
- Neuropathic arthropathy of the foot with and without superimposed osteomyelitis: MR imaging characteristics.Radiology. 2006; 238: 622-631
- Clinical and radiologic predictive factors of septic hip arthritis.AJR Am J Roentgenol. 2012; 199: 868-872
- The untoward effects of steroid treatment on the musculoskeletal system and what to do about them.J Asthma. 1992; 29: 363-368
- Muscle infarction in patients with diabetes mellitus: MR imaging findings.Radiology. 1999; 211: 241-247
- Musculoskeletal disorders of the hand and shoulder in patients with diabetes mellitus.Am J Med. 2002; 112: 487-490
Article info
Publication history
Published online: March 07, 2014
Accepted:
February 25,
2014
Received in revised form:
February 13,
2014
Received:
August 23,
2013
Footnotes
☆Grants received: none.
☆☆Disclosures: none.
★Conflict of interest: The authors declare that they have no conflict of interest.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.