Thyroid acropachy: correlation of imaging and pathology

Area of Science:

• Endocrinology and Rheumatology
• Medical Imaging

Background:

• Thyroid acropachy is a rare manifestation of autoimmune thyroid disease.
• It typically presents as soft tissue swelling of the hands and feet with insidious onset, clubbing, and characteristic periosteal reactions.
• It is often associated with exophthalmos and pretibial myxedema, forming a distinct clinical triad.

Observation:

• This case report focuses on a 65-year-old woman presenting with the classic triad of thyroid acropachy, exophthalmos, and pretibial myxedema.
• The study aims to demonstrate the characteristic imaging features of this syndrome.
• Notably, this case is the first to document the magnetic resonance imaging (MRI) features of thyroid dermopathy.

Findings:

• The imaging findings in this patient exemplify the typical presentation of thyroid acropachy, including soft tissue swelling and periosteal reactions.
• The co-occurrence of exophthalmos and pretibial myxedema alongside acropachy highlights the complete syndrome.
• The MRI evaluation provides novel insights into the imaging characteristics of thyroid dermopathy, a less commonly visualized component.

Implications:

• This case underscores the importance of recognizing thyroid acropachy as a potential manifestation of autoimmune thyroid disease.
• Comprehensive imaging, including MRI, can aid in the diagnosis and understanding of this rare syndrome.
• The documentation of MRI features for thyroid dermopathy may improve future diagnostic accuracy and patient management.