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Epithelioid Sarcoma
Joseph Junewick, MD FACR
over 6 years ago
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Case History

9 year old female with growth deceleration (75th percentile at age 6 to < 3rd percentile at age 9) found to be severely hypothyroid.

Case Detail

Anatomy: Musculoskeletal
Joseph Junewick, MD FACR
Diagnostic Category: Metabolic
Created: over 5 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: CR
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Reveal Findings

CR – Osteopenia with irregularly sclerotic zones at the physes and physeal equivalents.

Reveal Discussion

Hypothyroidism (decreased T3) has multiple effects on growth centers (physes and physeal equivalents): 1) Reduction in reserve zone chondrocytes, 2) Failure of proliferative chondrocyte organization into discrete columns, 3) Diminished hypertrophic zone, 4) Decreased vascular and osteoblastic invasion and 5) Altered matrix composition. These changes result in deficient mineralization of cartilage and osteoid and retarded enchondral ossification similar to rickets.

Reveal Diagnosis

Severe Juvenile Hypothyroidism

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