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Semin Musculoskelet Radiol 2021; 25(02): 246-259
DOI: 10.1055/s-0041-1727192
Review Article

Radiologic Imaging of Metabolic and Endocrine Disorders as They Affect the Hand and Wrist

Stephen Scullion
1   Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
,
Andrew J. Grainger
1   Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
,
Adam Greenspan
2   Department of Radiology, University of California School of Medicine, Sacramento, California
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Abstract

Metabolic and endocrine disorders have systemic effects on the musculoskeletal system, frequently producing characteristic changes in the hand and wrist. Radiographs historically played an instrumental role in the diagnostic pathway of many of these disorders, but the myriad of endocrinologic tests readily available to current clinicians may suggest their importance has lessened. We disagree. Recognition of these often subtle features can avoid the expense and psychological impact of an inappropriate diagnostic work-up, as well as expediting the diagnosis of potentially unsuspected disease. The metabolic and endocrine disorders discussed here are based on the distinctive changes produced around the hand and wrist.

Keywords

metabolic bone disease - hand - wrist - radiograph - magnetic resonance imaging

Financial Disclosure

Andrew J. Grainger's work is supported by the National Institute for Health Research, Cambridge Biomedical Research Centre.




Publication History

Article published online:
03 June 2021

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  • References

  • 1 Klein M, Bonar S, Freemont T, Vinh T, Lopez-Ben R. In: Non-Neoplastic Diseases of Bones and Joints (Atlas of Non-Tumor Pathology). Washington, DC: American Registry of Pathology; 2011: 894-902
    Google Scholar
  • 2 Guglielmi G, Muscarella S, Bazzocchi A. Integrated imaging approach to osteoporosis: state-of-the-art review and update. Radiographics 2011; 31 (05) 1343-1364
    CrossrefPubMedGoogle Scholar
  • 3 Richette P, Bardin T. Gout. Lancet 2010; 375 (9711): 318-328
    CrossrefPubMedGoogle Scholar
  • 4 Richette P, Doherty M, Pascual E. et al. 2018 updated European League Against Rheumatism evidence-based recommendations for the diagnosis of gout. Ann Rheum Dis 2020; 79 (01) 31-38
    CrossrefPubMedGoogle Scholar
  • 5 McQueen FM, Reeves Q, Dalbeth N. New insights into an old disease: advanced imaging in the diagnosis and management of gout. Postgrad Med J 2013; 89 (1048): 87-93
    CrossrefPubMedGoogle Scholar
  • 6 Girish G, Glazebrook KN, Jacobson JA. Advanced imaging in gout. AJR Am J Roentgenol 2013; 201 (03) 515-525
    CrossrefPubMedGoogle Scholar
  • 7 Grassi W, Okano T, Filippucci E. Use of ultrasound for diagnosis and monitoring of outcomes in crystal arthropathies. Curr Opin Rheumatol 2015; 27 (02) 147-155
    CrossrefPubMedGoogle Scholar
  • 8 Löffler C, Sattler H, Peters L, Löffler U, Uppenkamp M, Bergner R. Distinguishing gouty arthritis from calcium pyrophosphate disease and other arthritides. J Rheumatol 2015; 42 (03) 513-520
    CrossrefPubMedGoogle Scholar
  • 9 Ogdie A, Taylor WJ, Neogi T. et al. Performance of ultrasound in the diagnosis of gout in a multicenter study: comparison with monosodium urate monohydrate crystal analysis as the gold standard. Arthritis Rheumatol 2017; 69 (02) 429-438
    CrossrefPubMedGoogle Scholar
  • 10 Yang BY, Sartoris DJ, Djukic S, Resnick D, Clopton P. Distribution of calcification in the triangular fibrocartilage region in 181 patients with calcium pyrophosphate dihydrate crystal deposition disease. Radiology 1995; 196 (02) 547-550
    CrossrefPubMedGoogle Scholar
  • 11 Steinbach LS, Resnick D. Calcium pyrophosphate dihydrate crystal deposition disease revisited. Radiology 1996; 200 (01) 1-9
    CrossrefPubMedGoogle Scholar
  • 12 Teh J, McQueen F, Eshed I, Plagou A, Klauser A. Advanced imaging in the diagnosis of gout and other crystal arthropathies. Semin Musculoskelet Radiol 2018; 22 (02) 225-236
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Miksanek J, Rosenthal AK. Imaging of calcium pyrophosphate deposition disease. Curr Rheumatol Rep 2015; 17 (03) 20
    CrossrefPubMedGoogle Scholar
  • 14 Jäger HJ, Mehring U, Götz GF. et al. Radiological features of the visceral and skeletal involvement of hemochromatosis. Eur Radiol 1997; 7 (08) 1199-1206
    CrossrefPubMedGoogle Scholar
  • 15 Sahinbegovic E, Dallos T, Aigner E. et al. Musculoskeletal disease burden of hereditary hemochromatosis. Arthritis Rheum 2010; 62 (12) 3792-3798
    CrossrefPubMedGoogle Scholar
  • 16 Golding DN, Walshe JM. Arthropathy of Wilson's disease. Study of clinical and radiological features in 32 patients. Ann Rheum Dis 1977; 36 (02) 99-111
    CrossrefPubMedGoogle Scholar
  • 17 Feller ER, Schumacher HR. Osteoarticular changes in Wilson's disease. Arthritis Rheum 1972; 15 (03) 259-266
    CrossrefPubMedGoogle Scholar
  • 18 Klein M, Bonar S, Freemont T, Vinh T, Lopez-Ben R. In: Non-Neoplastic Diseases of Bones and Joints (Atlas of Non-Tumor Pathology). Washington, DC: American Registry of Pathology; 2011: 735-737
    CrossrefGoogle Scholar
  • 19 Prokaeva T, Spencer B, Kaut M. et al. Soft tissue, joint, and bone manifestations of AL amyloidosis: clinical presentation, molecular features, and survival. Arthritis Rheum 2007; 56 (11) 3858-3868
    CrossrefPubMedGoogle Scholar
  • 20 Siakallis L, Tziakouri-Shiakalli C, Georgiades CS, Shiakalli Chrysa T, Georgiades CS, Christos GS. Amyloidosis: review and imaging findings. Semin Ultrasound CT MR 2014; 35 (03) 225-239
    CrossrefPubMedGoogle Scholar
  • 21 Felea I, Fodor D, Schiotis R, Georgiu C, Bojan A, Rednic S. Ultrasound findings in AL musculoskeletal amyloidosis. Med Ultrason 2011; 13 (01) 76-79
    PubMedGoogle Scholar
  • 22 Narváez JA, Narváez J, Ortega R, De Lama E, Roca Y, Vidal N. Hypointense synovial lesions on T2-weighted images: differential diagnosis with pathologic correlation. AJR Am J Roentgenol 2003; 181 (03) 761-769
    CrossrefPubMedGoogle Scholar
  • 23 Brenton DP. Skeletal abnormalities in homocystinuria. Postgrad Med J 1977; 53 (622) 488-494 ; discussion 95–96
    CrossrefPubMedGoogle Scholar
  • 24 Brill PW, Mitty HA, Gaull GE. Homocystinuria due to cystathionine synthase deficiency: clinical-roentgenologic correlations. Am J Roentgenol Radium Ther Nucl Med 1974; 121 (01) 45-54
    CrossrefPubMedGoogle Scholar
  • 25 Smith SE, Murphey MD, Motamedi K, Mulligan ME, Resnik CS, Gannon FH. From the archives of the AFIP. Radiologic spectrum of Paget disease of bone and its complications with pathologic correlation. Radiographics 2002; 22 (05) 1191-1216
    CrossrefPubMedGoogle Scholar
  • 26 Theodorou DJ, Theodorou SJ, Kakitsubata Y. Imaging of Paget disease of bone and its musculoskeletal complications: review. AJR Am J Roentgenol 2011; 196 (6, Suppl): S64-S75
    CrossrefPubMedGoogle Scholar
  • 27 Friedman AC, Orcutt J, Madewell JE. Paget disease of the hand: radiographic spectrum. AJR Am J Roentgenol 1982; 138 (04) 691-693
    CrossrefPubMedGoogle Scholar
  • 28 Chang CY, Rosenthal DI, Mitchell DM, Handa A, Kattapuram SV, Huang AJ. Imaging findings of metabolic bone disease. Radiographics 2016; 36 (06) 1871-1887
    CrossrefPubMedGoogle Scholar
  • 29 Jevtic V. Imaging of renal osteodystrophy. Eur J Radiol 2003; 46 (02) 85-95
    CrossrefPubMedGoogle Scholar
  • 30 Murphey MD, Sartoris DJ, Quale JL, Pathria MN, Martin NL. Musculoskeletal manifestations of chronic renal insufficiency. Radiographics 1993; 13 (02) 357-379
    CrossrefPubMedGoogle Scholar
  • 31 Resnick D. Hypoparathyroidism. In: Diagnosis of Bone and Joint Disorders. Philadelphia, PA: Saunders; 1995: 2061-2064
    Google Scholar
  • 32 Wilson LC, Hall CM. Albright's hereditary osteodystrophy and pseudohypoparathyroidism. Semin Musculoskelet Radiol 2002; 6 (04) 273-283
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Tuchendler D, Bolanowski M. The influence of thyroid dysfunction on bone metabolism. Thyroid Res 2014; 7 (01) 12
    CrossrefPubMedGoogle Scholar
  • 34 Podgorski M, Robinson B, Weissberger A, Stiel J, Wang S, Brooks PM. Articular manifestations of acromegaly. Aust N Z J Med 1988; 18 (01) 28-35
    CrossrefPubMedGoogle Scholar
  • 35 Anton HC. Hand measurements in acromegaly. Clin Radiol 1972; 23 (04) 445-450
    CrossrefPubMedGoogle Scholar