Less Common Arthropathies

B. Rheumatic Disease and Endocrinopathies
  • Peter A. Merkel


  • 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.


Carpal Tunnel Syndrome Joint Space Widening Joint Laxity Diffuse Idiopathic Skeletal Hyperostosis Adhesive Capsulitis 
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© 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

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