Arthropathy in hypothyroidism

Symptoms of joint damage sometimes preceded by the classical symptoms of hypothyroidism.

Hypothyroidism - a condition associated with a reduced content of thyroid hormones in the body, usually occurring with slowing metabolism and accumulation of metabolites.This leads to the development of metabolic and degenerative changes in the organs and tissues and the formation of myxedema - mucosal edema, which occurs due to the accumulation of mucopolysaccharides in the tissues.

main causes of hypothyroidism

At the heart of hypothyroidism is often insufficient production of hormones by the thyroid gland.In connection with this are two types of disease.

  • Primary hypothyroidism is associated with impaired production of hormones directly in the gland when iodine deficiency in food, the surgical removal of part or all of the thyroid gland, thyroiditis, an overdose thyreostatics, radiation sickness.
  • Secondary hypothyroidism is associated with insufficient production of thyroid-stimulating hormone by the pit
    uitary gland or hypothalamus thyrotropin-releasing hormone in their disease (tumor, trauma, vascular disease of the pituitary or hypothalamus, etc.).

Features of development and manifestation of arthropathy in hypothyroidism

  • arthropathy occurs in a quarter of all patients with myxedema, hitting at the same time in the main joints of the lower limbs and the small joints of the hand.
  • Many patients with prolonged duration of hypothyroidism develops diffuse systemic osteoporosis.
  • Manifestations gipotireoznogo arthritis usually nonspecific: pain and swelling in the joints, limiting the range of motion in them, the accumulation of effusion in the joint cavity.
  • In 10% of patients have the index finger syndrome (pain when bending), in 22% of patients with hypothyroidism develop Dupuytren's contracture, a third of patients develop carpal tunnel syndrome.This is due to swelling of the para-articular tissues, associated phenomena tenosynovitis, deposition of mucopolysaccharides in paraartrikulyarnyh tissues, and prolonged existence and chondrocalcinosis.
  • In some cases, changes in the joints precede the manifestation of typical symptoms of hypothyroidism on the part of other organs and systems.But at the same time can be traced myalgia (muscle pain), weakness, fatigue.

Diagnostics arthropathy in hypothyroidism

If the diagnosis of "hypothyroidism" is set previously, the diagnosis of arthropathy is not particularly difficult for a specialist.Usually it further includes ultrasound of joints and para-articular tissues, X-ray examination of joints (osteoporosis can be detected, chondrocalcinosis).

With ultrasonic and X-ray densitometry set the severity of osteoporosis.A detection of a low content of thyroid stimulating hormone in serum suggests hypothyroidism secondary nature, with a high level of TSH suggest primary hypothyroidism.Also, if necessary the determination of calcium in blood serum vitamin D metabolites and other biochemical parameters.

arthropathy Treatment of hypothyroidism

As a rule, for the treatment of hypothyroidism use replacement therapy of thyroid hormones, symptomatic therapy.

to replenish calcium deficiency and increase bone density using bisphosphonates, calcium supplements with vitamin D3 and other drugs given endocrinologist and / or rheumatologist.

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