Retrosternal goitre with subclinical hyperthyroidism presenting with trochanteric fracture

Area of Science:

• Endocrinology
• Orthopedics
• Geriatric Medicine

Background:

• A 55-year-old female presented with a trochanteric fracture of the right femur.
• Initial investigations revealed a large retrosternal goiter compressing great vessels, present asymptomatically for over two decades.

Observation:

• The patient's retrosternal goiter was diagnosed as toxic multinodular goiter with subclinical hyperthyroidism.
• This endocrine disorder is a potential cause of secondary osteoporosis.

Findings:

• The patient experienced a trochanteric femur fracture, possibly linked to secondary osteoporosis.
• The co-existence of a long-standing, asymptomatic retrosternal goiter and a femur fracture in this patient is unusual.

Implications:

• This case highlights the importance of considering underlying endocrine disorders in patients with osteoporosis and fractures.
• Early diagnosis and management of toxic multinodular goiter can prevent skeletal complications.
• The unusual presentation underscores the need for comprehensive patient evaluation.