Abstract
Plain knee radiographs of 20 neonates with congenital hypothyroidism, were reviewed. The size and appearances of the epiphyses were compared with the biochemical data at the time of referral. Fifteen infants had unequivocal evidence of delayed bone maturation based on absence of the distal femoral epiphysis or small epiphyseal size. Seven cases had fragmentation of at least one epiphysis. A positive correlation was found, at diagnosis, between the thyroxine and triiodothyronine levels and the size of the knee epiphyses. All 14 infants with thyroxine levels of less than 70 nmol/l had small epiphyses with a combined mean diameter of the proximal tibial plus distal femoral epiphyses of 7 mm or less. Conversely, of the 6 infants with thyroxine levels of 70 nmol/l or above, 5 had combined epiphyseal diameters of greater than 10 mm. We suggest that in infants with no clinical symptoms and only moderately raised raised screening thyroid stimulating hormone, a knee radiograph showing the described radiological changes should prompt institution of thyroxine treatment before awaiting biochemical confirmation of the diagnosis.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Illig R., Largo R. H., Weber M., Augsburger T., Lipp A., Wissler D., Perrenoud A. E., Torresani T. Sixty children with congenital hypothyroidism detected by neonatal thyroid: mental development at 1, 4, and 7 years: a longitudinal study. Acta Endocrinol Suppl (Copenh) 1986;279:346–353. doi: 10.1530/acta.0.112s346. [DOI] [PubMed] [Google Scholar]
- Moschini L., Costa P., Marinelli E., Maggioni G., Sorcini Carta M., Fazzini C., Diodato A., Sabini G., Grandolfo M. E., Carta S. Longitudinal assessment of children with congenital hypothyroidism detected by neonatal screening. Helv Paediatr Acta. 1986 Dec;41(5):415–424. [PubMed] [Google Scholar]
- Sénécal J., Grosse M. C., Vincent A., Simon J., Lefrèche J. N. Maturation osseuse du foetus et du nouveau-né. Arch Fr Pediatr. 1977 May;34(5):424–438. [PubMed] [Google Scholar]
- Wolter R., Noël P., De Cock P., Craen M., Ernould C., Malvaux P., Verstaeten F., Simons J., Mertens S., Van Broeck N. Neuropsychological study in treated thyroid dysgenesis. Acta Paediatr Scand Suppl. 1979;277:41–46. doi: 10.1111/j.1651-2227.1979.tb06190.x. [DOI] [PubMed] [Google Scholar]
- von HARNACK G. [The post-mature, underweight newborn infant]. Monatsschr Kinderheilkd. 1960 Sep;108:412–415. [PubMed] [Google Scholar]