Image and content excerpted from the VisualDx clinical decision support system.
VisualDx images show variation in age, skin color, and disease stage. VisualDx has 5 images of Thyroid Acropachy.
Full text and additional images for Thyroid Acropachy are available in the following VisualDx packages:
E05.90 – Thyrotoxicosis, unspecified without thyrotoxic crisis or storm
242.90 – Thyrotoxicosis without goiter or other cause and without thyrotoxic crisis or storm
SynopsisThyroid acropachy is a triad consisting of digital clubbing, soft tissue swelling of the hands and feet, and periosteal new bone formation. It is a rare manifestation of thyrotoxicosis with an incidence of 0.1–1.0% of patients with Graves' disease. Thyroid acropachy is usually associated with exophthalmos and pretibial myxedema.
The first, second, and fifth metacarpals, the proximal phalanges of the hand, and the first metatarsal and proximal phalanges of the feet are most commonly affected.
In addition to thyroid acropachy, patients with thyrotoxicosis can develop a characteristic onycholysis in which the free edge of the nail is undulated and curved upward (Plummer's nails). The fourth fingernails are initially involved. The nails are fragile, and the nail bed of the toes may be hyperpigmented.