Radiological signs of bone loss in hyperthyroidism

Koutras, D. A.; Pandos, P. G.; Koukoulommati, A. S.; Constantes, J.

doi:10.1259/0007-1285-46-549-695

Cited by 9 publications

(5 citation statements)

References 12 publications

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“…Hyperthyroidism is a recognized cause of osteoporosis and vertebral compression fractures (24). It is, therefore, somewhat surprising that studies of BMD in the appendicular skeleton have shown only marginal decreases (25).…”

Section: -Umentioning

confidence: 99%

Differential effects of endocrine dysfunction on the axial and the appendicular skeleton.

Seeman¹,

Wahner²,

Offord³

et al. 1982

J. Clin. Invest.

438

145

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A B S T R A C T In 100 patients with various types of endocrine dysfunction, we measured bone mineral density (BMD) at the midradius (>95% cortical bone) and distal radius (75% cortical and 25% trabecular bone) by single photon absorptiometry and at the lumbar spine (>66% trabecular bone) using the new technique of dual photon absorptiometry. BMD in each endocrine disorder deviated in at least one site from the sex-specific age regression of 187 normal subjects. For patients with primary hyperparathyroidism, hypercortisolism, and hyperthyroidism this deviation was negative (suggesting bone loss), whereas for patients with secondary hyperparathyroidism due to chronic renal failure, acromegaly, and postsurgical hypoparathyroidism it was positive (suggesting bone gain). When all six states of endocrine dysfunction were compared concomitantly by multivariate analysis of variance, the profile of the changes in BMD differed significantly (P < 0.001), indicating a nonuniform response of bone to the various hormonal alterations. When values for BMD at each of the three scanning sites were compared, the midradius and distal radius did not differ significantly; either of the radius measurements, however, differed significantly (P < 0.001) from the lumbar spine. Thus, the BMD of the axial skeleton cannot be reliably predicted from measurements made in the appendicular skeleton. We conclude that the effects of endocrine dysfunction on bone density are complex and are both disease and site specific.

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Section: -Umentioning

confidence: 99%

Differential effects of endocrine dysfunction on the axial and the appendicular skeleton.

Seeman¹,

Wahner²,

Offord³

et al. 1982

J. Clin. Invest.

438

145

View full text Add to dashboard Cite

show abstract

“…Radiological signs of hyperthyroid bone disease vary between 3.5 and 50% [5], depending on the severity of the disease as well as on the observer, as it is a purely subjective assessment. Bone densitometry devices are used in assessing hyperthyroid bone disease and these often detect the skeletal complications that accompany hyperthyroidism, even when biochemical or radiological evidence of bone disease is absent [6].…”

mentioning

confidence: 99%

Bone Mineral Density and Metabolic Indices in Hyperthyroidism

et al. 1991

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Hyperthyroidism can alter bone metabolism by increasing both bone resorption and formation. The increase in bone resorption predominates, leading to a decrease in bone mass. To assess the effect of hyperthyroidism on bone and mineral metabolism, we measured bone density using single photon absorptiometry in 30 untreated hyperthyroid patients. Patients were categorized into three groups based on sex and alkaline phosphatase levels: 44 sex-and agematched subjects were used as controls. Bone densities were significantly lower in all patient groups compared with controls. Alkaline phosphatase was found to be a useful marker for assessing severity of bone disease in hyperthyroid patients as there is significant correlation between the alkaline phosphastase level and degree of bone loss and decrease in bone density among patients with higher alkaline phosphatase value. Hyperthyroidism should be considered in the differential diagnosis of unexplained elevated alkaline phosphatase activity. Bone Mineral Density and Metabolic Indices in Hyperthyroidism. 1991; 11(5): 530-533 Thyroid disorders such as hyperthyroidism have profound effects on bone and mineral metabolism [1]. The skeletal changes in hyperthyroidism can be grouped into two main categories: first, localized changes in the fingers, consisting of periosteal hyperplasia leading to clubbing, a condition known as thyroid acropathy, which has been reported to occur in about 1% of the thyrotoxic patients; and second, a generalized loss of bone mass, taking the form of osteoporosis [2].There is a negative correlation between the duration of the disorder and the bone mass. Hyperthyroidism causes increased bone turnover leading to osteopenia and increased incidence of fracture [3].Both osteoblastic and osteoclastic activities are increased, with bone resorption exceeding bone formation.Bone biopsy usually shows decreased trabecular bone volume and increased cortical porosity [4]. Radiological signs of hyperthyroid bone disease vary between 3.5 and 50% [5], depending on the severity of the disease as well as on the observer, as it is a purely subjective assessment. Bone densitometry devices are used in assessing hyperthyroid bone disease and these often detect the skeletal complications that accompany hyperthyroidism, even when biochemical or radiological evidence of bone disease is absent [6].Single photon absorptiometry (SPA) is used to assess appendicular bones only, as tissue composition surrounding the bone mass has to be uniform and minimal. The method was based on the principle described by Cameron et al [7]. SPA was used in this study to examine the effect of hyperthyroidism on bone metabolism.

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“…Até o término do período experimental ocorreu um gradual decréscimo dos valores médios da densidade mineral óssea, mantendo-se cada vez menores os valores densitométricos (Tabela 4). Alterações desta natureza já foram amplamente descritas na medicina humana 5,6,7,9,13,14,15,16,27 , entretanto, poucos autores relatam este fato em animais 1,8,17,27 .…”

Section: Resultsunclassified

“…A partir de radiografias convencionais em humanos, a visualização de manifestações ósseas nos casos de tirotoxicose endógena é de rara ocorrência 9 Nesta pesquisa, este acontecimento também foi verificado na tirotoxicose experimental. Radiograficamente não foi possível estabelecer o diagnóstico de perda de massa óssea nos gatos estudados a partir de radiografias simples.…”

Section: Resultsunclassified

“…Em humanos, o hipertiroidismo é conhecido como um distúrbio capaz de promover osteoporose como conseqüência do aumento da taxa de reabsorção óssea 5,6 . Desta forma, a ocorrência da doença é considerada como um fator de risco para desmineralização óssea, podendo estar correlacionada com o diagnóstico de fraturas patológicas 5,7,8,9,10,11,12,13,14 .…”

Section: Introductionunclassified

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Determinação de desmineralização óssea em gatos após tirotoxicose experimental

Costa

Cardoso²,

Muniz

et al. 2006

Braz. J. Vet. Res. Anim. Sci.

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O hipertiroidismo é capaz de proporcionar efeitos sobre o metabolismo ósseo tanto em humanos como em animais. Para melhor avaliar este fato em gatos, em 16 animais foram induzidos a tirotoxicose a partir da administração oral de 150 µg/kg de levotiroxina sódica a cada 24 horas durante 42 dias. Os níveis hormonais foram avaliados por radioimunoensaio e a densidade mineral óssea da extremidade distal do rádio direito foi mensurada através de densitometria óptica radiográfica. Foi possível observar, a partir da primeira semana de experimento, significativa elevação sérica de T4 livre e T4 total acompanhada de desmineralização óssea do rádio.

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Radiological signs of bone loss in hyperthyroidism

Cited by 9 publications

References 12 publications

Differential effects of endocrine dysfunction on the axial and the appendicular skeleton.

Differential effects of endocrine dysfunction on the axial and the appendicular skeleton.

Bone Mineral Density and Metabolic Indices in Hyperthyroidism

Determinação de desmineralização óssea em gatos após tirotoxicose experimental

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