Congenital Hypothyroidism

  • Etiology: Thyroid hormone deficiency
  • Imaging Radiograph:
    — Overall: Marked delay in the appearance of ossification centers and skeletal maturation, skeletal maturation when measured by bone age usually 4 standard deviations below the mean for chronologic age, when epiphyses appear they are dysplastic and fragmented due to slow endochondral bone formation
    — Skull: Multiple wormian bones, relatively large sella
    — Spine: Kyphosis, flattening of vertebral bodies, increased width of intervertebral disc space, bullet-shaped vertebral bodies at L1 and L2
    — Long bones: Shortened
  • DDX: Epiphyseal dysplasias
  • Complications:
  • Treatment:
  • Clinical: Short stature and intellectual disability

Radiology Cases of Congenital Hypothyroidism

Radiograph of Wormian bones
Lateral radiograph of the skull shows a relatively enlarged sella and multiple Wormian bones.
Radiograph of hand in congenital hypothyroidism
AP radiograph of the hand shows an absence of any ossification centers in the hand.
Spine radiograph of congenital hypothyroidism
Lateral radiograph of the spine shows increased width of the intervertebral disc spaces in the spine.
AXR of congenital hypothyroidism
AXR AP shows bilateral absence of the femoral ossification centers.