Bone and Soft-Tissue Disorders
Hypothyroidism during Childhood = Cretinism
Frequency: 1÷4,000 live births have congenital hypothyroidism
Cause: sporadic hypoplasia / ectopia of thyroid
- delayed skeletal maturation (= delayed appearance + growth of ossification centers, delayed epiphyseal closure)
- fragmented stippled epiphyses
- wide sutures / fontanels with delayed closure
- delayed dentition
- delayed / decreased pneumatization of sinuses + mastoids
- hypertelorism
- dense vertebral margins
- demineralization
- hypoplastic phalanges of 5th finger
MR:
- reduced myelination of brain (usually beginning during midgestation)
OB-US:
- fetal goiter (especially in hyperthyroid mothers treated with methimazole / propylthiouracil / 131I)
Hypothyroidism during Adulthood
- calvarial thickening / sclerosis
- wedging of dorsolumbar vertebral bodies
- coxa vara with flattened femoral head
- premature atherosclerosis
- No skeletal changes with adult onset!
Outline