ContentsSynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferencesView all Images (7)
Thyroid acropachy - Nail and Distal Digit
Print
Other Resources UpToDate PubMed

Thyroid acropachy - Nail and Distal Digit

Print Images (7)
Contributors: Bertrand Richert MD, Robert Baran MD
Other Resources UpToDate PubMed

Synopsis

Thyroid 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.

Codes

ICD10CM:
E05.90 – Thyrotoxicosis, unspecified without thyrotoxic crisis or storm

SNOMEDCT:
237826006 – Thyroid acropachy

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

References

Subscription Required

Last Updated: 01/19/2015
Copyright © 2019 VisualDx®. All rights reserved.
Thyroid acropachy - Nail and Distal Digit
Print 7 Images
View all Images (7)
(with subscription)
Thyroid acropachy : Joint swelling, Nail clubbing, Periosteal reaction
Clinical image of Thyroid acropachy
Copyright © 2019 VisualDx®. All rights reserved.