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Hashimoto's thyroiditis presenting as bilateral knee arthropathy
M Monem Gillan1, R Hal Scofield, John B Harley
1Division of Endocrinology, Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Summary
Hashimoto's thyroiditis can initially present as joint pain, even without other hypothyroidism symptoms. Early diagnosis and thyroid hormone replacement effectively reverse these rheumatic manifestations.
Area of Science:
- Endocrinology
- Rheumatology
- Immunology
Background:
- Hashimoto's thyroiditis is an autoimmune condition leading to hypothyroidism.
- Hypothyroidism can manifest with various symptoms, including rheumatic complaints.
- Musculoskeletal symptoms may be the primary presentation of hypothyroidism.
Observation:
- A case study highlights knee pain as the sole presenting symptom in a patient with Hashimoto's thyroiditis.
- Lab tests confirmed hypothyroidism secondary to Hashimoto's thyroiditis.
- Synovial fluid analysis revealed a non-inflammatory state.
Findings:
- Hypothyroidism-related arthralgia, arthritis, and stiffness were observed.
- Knee effusions, characterized by a sluggish bulge sign due to viscous synovial fluid, are associated with hypothyroidism.
- Symptoms were fully reversible with thyroid hormone replacement therapy.
Implications:
- Emphasizes the importance of considering hypothyroidism in patients with unexplained joint pain.
- Suggests early diagnosis and treatment by primary care physicians can prevent severe rheumatic complications.
- Highlights the potential for preventing polyarthritis associated with hypothyroidism through timely intervention.