Case series of orthopaedic complications associated with endocrine disorders presented at tertiary care center and review of literature

Abstract

Endocrine glands affecting skeletal system are parathyroid glands, adrenal glands, pituitary gland, thyroid and gonads. If any abnormality occurs in these glands, they cause structural and functional impairment of the skeletal system. Early diagnosis and treatment of these endocrine problems and ruling out musculoskeletal involvement helps to maintain skeletal integrity and prevent osteoporotic fractures and chronic bone pathologies. Here we present a case series of 4 patients who came to us with chronic bone pathologies or post-traumatic fractures associated with endocrine abnormalities­; such as parathyroid adenoma (hyperparathyroidism), Cushing’s syndrome and thyroid adenocarcinoma. One patient with osteoporotic and pathological fracture was managed operatively and sent for management of endocrine pathology and other three patients after evaluating cause for the bone pathology were referred for primary management of endocrine disease. Osteoclasts and osteoblasts of the bone are affected by the endocrine hormones, such as parathyroid hormone, thyroid, glucocorticoids and gonadotropins. Any abnormality in these hormones leads to alteration of bone mineral density. Hyperthyroidism, glucocorticoid excess, hyperparathyroidism, hypogonadism, and acromegaly decrease bone mineral density and aggravate the osteoporotic tendencies and leading to orthopaedic complications. As an orthopaedic practitioner we should be well aware of endocrine disorders affecting bones. Early diagnosis and treatment of these endocrine problems in older patients helps to maintain their skeletal integrity, prevent osteoporotic fracture and orthopaedic complications.