Endocrine Arthropathies



Endocrine Arthropathies


Michael D. LockshinH




The musculoskeletal manifestations of endocrine diseases include muscle dysfunction, disorders of bone metabolism, and cartilage deformation.

Tendons, ligaments, and tendon attachment sites are regularly symptomatic for example symptoms are more often periarticular than articular. Crystal arthropathies and calcific tendinitis may be symptoms of endocrine disease.



CLINICAL MANIFESTATIONS

Endocrinopathic musculoskeletal disease tends to be diffuse and poorly described.

Except for crystal arthritis, it is more often periarticular than articular. Table 55-1 lists the rheumatic manifestations of common endocrinopathies.








Table 55-1 Rheumatic Manifestations of Common Endocrinopathies




























































Endocrine abnormality Rheumatic Manifestations Putative pathogenesis
Thyroid—hyper Proximal myopathy
Thyroid acropachy
Myalgia (during changing thyroid states)
Muscle/protein metabolism
Growth hormone
Unknown
Thyroid—hypo High creatine kinase
Bland joint effusion
Chondrocalcinosis
Hyperuricemia
Myalgia (during changing thyroid states)
Osteonecrosis-type joint damage that may necessitate joint replacement
Muscle membrane abnormality
Abnormal cartilage metabolism
Unknown
Renal tubular dysfunction
Unknown
Unknown
Parathyroid—hyper Osteopenia, bone resorption, fractures, cysts, myopathy, and pseudogout Hypercalcemia increased osteoclast activity
Parathyroid—hypo Osteopenia Decreased osteoblast activity
Parathyroid—hypo (congenital) Short stature and short metacarpals Unknown
Pituitary—hyper Increased cartilage growth, accelerated osteoarthritis, and osteopenia Growth hormone excess and abnormal joint mechanics
Pituitary—hypo Short stature and osteopenia Lack of growth hormone
Adrenal—hyper Osteopenia Effect on calcium metabolism and osteoblasts and osteoclasts
  Proximal myopathy Muscle protein catabolism and hypokalemia
Gonads—hyper Short stature Premature closure of epiphyses
Gonads—hypo Osteopenia Unopposed osteoclast activity
Pancreas (diabetes) Charcot joints
Eheiroarthropathy
Dupuytren’s contracture
Palmar fasciitis
Carpal tunnel syndrome
Septic arthritis or osteomyelitis
Scleredema
Neuropathy
Unknown
Unknown
Unknown
Unknown
Increased infection risk in DM
Unknown
Hemochromatosis Pyrophosphate arthropathy
Hooks on metacarpophalangeal Joints
Iron deposition in cartilage
Unknown
DM, diabetes mellitus.

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Jul 29, 2016 | Posted by in RHEUMATOLOGY | Comments Off on Endocrine Arthropathies
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