My Orthopaedic Surgeon

Cretinism: "condition due to congenital lack of thyroid hormone, marked by arrested physical and mental development, dystrophy of the bones and soft parts, and lowered basal metabolism; it is the congenital form of thyroid deficiency, while myxedema is the acquired form." Source: CRISP Thesaurus, 2006 "A condition in infancy or early childhood due to an in-utero deficiency of THYROID HORMONES that can be caused by genetic or environmental factors, such as thyroid dysgenesis or HYPOTHYROIDISM in infants of mothers treated with THIOURACIL during pregnancy. Endemic cretinism is the result of iodine deficiency. Clinical symptoms include severe MENTAL RETARDATION, impaired skeletal development, short stature, and MYXEDEMA." Source: Medical Subject Headings, 2007_2006_08_08

In Human Nutrition in the Developing World Iodine deficiency is responsible not only for very widespread endemic goitre and cretinism, but also for retarded physical growth and intellectual development and a variety of other conditions. These conditions together are now termed iodine deficiency disorders (IDD). They are particularly important because: · perhaps one-quarter of the world's people consume inadequate amounts of iodine; · the disorders have a major impact on the individual and on society; · of the four major deficiency diseases, IDD is the easiest to control.

Objectives 1. Discuss the effect of thyroid hormone on normal growth 2. Describe the clinical features of hypothyroidism in children 3. Describe radiographic findings associated with hypothyroidism 4. Describe the effect of calcitonin on bone and kidney 5. Discuss the orthopaedic condition most associated with hypothyroidism in children Thyroid function plays a critical role in the normal growth and development of children. Cretinism, an unambiguously unflattering term, is used to describe the effects of hypothyroidism in the newborn. Affected infants demonstrate short stature, mental retardation, developmental delay, coarse hair, constipation, and a protruding tongue. In the older child, the major features are related to growth delay and lethargy. Sluggish reflexes are an important physical sign of hypothyroidism.

This is a collection of six essays : three which originally appeared in the Edinburgh Medical Journal, one which was off-printed from the Lancet, and two which were read before the Medico-Chirurgical Society of Edinburgh. Thomson, John. Edinburgh : Oliver and Boyd, 1891-93.