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Aseptic Necrosis of Bone in Myxedema

HERBERT M. RUBINSTEIN, M.D., F.A.C.P.; and MARION H. BROOKS, M.D., F.A.C.P.
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Department of Medicine
Loyola University Stritch School of Medicine
Maywood, IL 60153


Ann Intern Med. 1977;87(5):580-581. doi:10.7326/0003-4819-87-5-580
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Growth retardation and delayed skeletal maturation are well-known manifestations of cretinism and juvenile myxedema. Patients with these conditions have abnormal ossification of epiphyseal centers that may appear porous, stippled, or fragmented on roentgenogram (epiphyseal dysgenesis). These changes are most pronounced in large ossification centers such as the femoral head and tarsal navicular. In the femoral head, clinical and radiographic features resemble Legg-Calvé-Perthes disease, but there are marked differences in pathology and response to thyroid hormone administration (1, 2). In the adult, thyroid hormone deficiency is associated with decreased metabolic activity and remodeling of bone (2), but overt skeletal disease has

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