Advertisement

Less Common Arthropathies

B. Rheumatic Disease and Endocrinopathies
  • Peter A. Merkel

Abstract

  • Musculoskeletal signs and symptoms frequently occur in endocrinopathies.

  • A number of syndromes of limited joint mobility occur in people with diabetes mellitus, including diabetic hand syndrome (diabetic cheiroarthropathy), adhesive capsulitis (frozen shoulder, periarthritis), Dupuytren’s contractures, trigger finger (flexor tenosynovitis), diffuse idiopathic skeletal hyperostosis (DISH syndrome), neuropathic arthritis (Charcot joints, diabetic osteoarthropathy), and diabetic muscle infarction.

  • Hyperthyroidism may be associated with proximal myopathy, usually without serum creatine kinase (CK) elevation; thyroid acropachy; and drug-induced vasculitis associated with antineutrophil cytoplasmic antibodies (ANCA), usually caused by propylthiouracil.

  • Hypothyroidism may be associated with polyarthralgias, carpal tunnel syndrome, and proximal myopathy, with serum CK elevation.

  • Hyperparathyroidism may cause osteoporosis, osteitis fibrosa cystica, chondrocalcinosis, and pseudogout.

  • ■ Other endocrinopathies that may lead to musculoskeletal complaints are hypoparathyroidism, acromegaly, and glucocorticoid-induced Cushing’s syndrome.

Keywords

Carpal Tunnel Syndrome Joint Space Widening Joint Laxity Diffuse Idiopathic Skeletal Hyperostosis Adhesive Capsulitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Pastan RS, Cohen AS. The rheumatologic manifestations of diabetes mellitus. Med Clin North Am 1978;62: 829–839.PubMedGoogle Scholar
  2. 2.
    Crisp AJ, Heathcote JG. Connective tissue abnormalities in diabetes mellitus. J R Coll Phys Lond 1984;18:132–141.Google Scholar
  3. 3.
    Schulte L, Roberts MS, Zimmerman C, Ketler J, Simon LS. A quantitative assessment of limited joint mobility in patients with diabetes. Goniometric analysis of upper extremity passive range of motion. Arthritis Rheum 1993; 36:1429–1443.PubMedCrossRefGoogle Scholar
  4. 4.
    Mavrikakis ME, Drimis S, Kontoyannis DA, Rasidakis A, Moulopoulou ES, Kontoyannis S. Calcific shoulder periarthritis (tendinitis) in adult onset diabetes mellitus: a controlled study. Ann Rheum Dis 1989;48:211–214.PubMedGoogle Scholar
  5. 5.
    Sinha S, Munichoodappa CS, Kozak GP. Neuro-arthropathy (Charcot joints) in diabetes mellitus (clinical study of 101 cases). Medicine (Baltimore) 1972;51:191–210.CrossRefGoogle Scholar
  6. 6.
    Krendel DA. Costigan DA, Hopkins LC. Successful treatment of neuropathies in patients with diabetes mellitus [see comments]. Arch Neurol 1995;52:1053–1061.PubMedGoogle Scholar
  7. 7.
    Grigoriadis E, Fam AG, Starok M, Ang LC. Skeletal muscle infarction in diabetes mellitus. J Rheumatol 2000; 27:1063–1068.PubMedGoogle Scholar
  8. 8.
    Bland JH, Frymoyer JW. Rheumatic syndromes of myxedema. N Engl J Med 1970;282:1171–1174.PubMedCrossRefGoogle Scholar
  9. 9.
    Bland JH, Frymoyer JW, Newberg AH, Revers R, Norman R. Rheumatic syndromes in endocrine disease. Semin Arthritis Rheum 1979;9:23–65.PubMedCrossRefGoogle Scholar
  10. 10.
    Wartofsky L. Levothyroxine therapy and osteoporosis. An end to the controversy? Arch Intern Med 1995;155: 1130–1131.PubMedCrossRefGoogle Scholar
  11. 11.
    Merkel P. Drugs associated with vasculitis. Curr Opin Rheumatol 1998;10:45–50.PubMedCrossRefGoogle Scholar
  12. 12.
    Alexander GM, Dieppe PA, Doherty M, Scott DG. Pyrophosphate arthropathy: a study of metabolic associations and laboratory data. Ann Rheum Dis 1982;41:377–381.PubMedCrossRefGoogle Scholar
  13. 13.
    Bluestone R, Bywaters EG, Hartog M, Holt PJ, Hyde S. Acromegalic arthropathy. Ann Rheum Dis 1971;30:243–258.PubMedGoogle Scholar
  14. 14.
    Phillips KA, Nance EP Jr, Rodriguez RM, Kaye JF. Avascular necrosis of bone: a manifestation of Cushing’s disease. South Med J 1986;79:825–829.PubMedGoogle Scholar
  15. 15.
    Plonk JW, Feldman JM. Carcinoid arthropathy. Arch Intern Med 1974;134:651–654.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC. 2008

Authors and Affiliations

  • Peter A. Merkel
    • 1
  1. 1.Department of Medicine, Section of RheumatologyBoston University School of MedicineBostonUSA

Personalised recommendations