BONE AND JOINT MANIFESTATIONS OF HYPOTHYROIDISM
BONE AND JOINT MANIFESTATIONS OF HYPOTHYROIDISM
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DOI：
10.1016/s0049-0172(95)80038-7
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发表时间：
1995-02-01
影响因子：
5
通讯作者：
PODELL, DN
中科院分区：
文献类型：
--
作者：
MCLEAN, RM;PODELL, DN
甲状腺功能减退经常伴有肌肉骨骼表现，从肌痛和关节痛到真正的肌病和关节炎。一个案例是提出了一个关节病过程在髋关节是孤立的发现在一个年轻的男子严重甲状腺功能减退。本文回顾了以往关于甲状腺功能减退症的骨骼和关节表现的文献，重点介绍了这些表现为甲状腺功能障碍症状的病例。成人公认的甲状腺功能减退症的大多数关节病改变累及膝关节和手部，而儿童更常累及髋关节和股骨头骨骺。已知甲状腺激素在细胞水平上对骨和软骨的增殖和分化有影响。甲状腺功能减退状态似乎会引起这些组织的异常，导致诸如骨骺发育不良、无菌性坏死、可能的晶体性关节炎和以高度粘稠的非炎性关节积液为主的关节病变，主要影响膝关节、手腕和手部。神经病变和肌病症状伴随甲状腺功能减退可能表现为关节区域异常，而实际上没有潜在的关节病。
Hypothyroidism is frequently accompanied by musculoskeletal manifestations ranging from myalgias and arthralgias to true myopathy and arthritis. A case is presented in which an arthropathic process in the hip was the isolated finding in a young man who was severely hypothyroid. Previous literature on bone and joint manifestations of hypothyroidism is reviewed, with emphasis on cases where such manifestations were the presenting symptoms of thyroid dysfunction. Most cases of arthropathic changes in adult-recognized hypothyroidism involved the knees and hands, while the hip and the epiphysis of the femoral head appear more commonly involved in children. Thyroid hormones have known effects at the cellular level on proliferation and differentiation of bone and cartilage. The hypothyroid state appears to induce abnormalities in these tissues, which result in such clinical manifestations as epiphyseal dysgenesis, aseptic necrosis, possibly crystal-induced arthritis, and an arthropathy characterized by highly viscous noninflammatory joint effusions primarily affecting the knees, wrists, and hands. Neuropathic and myopathic symptoms accompanying hypothyroidism may manifest as joint region abnormalities when in fact there is no underlying arthropathy.