Clinical Atlas in Endocrinology and Diabetes: A Case-based Compendium Nihal Thomas, Felix Jebasingh K, Mathews Edatharayil Kurian
INDEX
ABCDEFGHIJKLMNOPQRSTUVWXZ
Page numbers followed by f refer to figure and t refer to table.
A
Abdomen 78f, 79f, 95, 96, 96f, 171, 191f, 218, 220f, 223f, 224f, 466f, 480f, 483f
ultrasonography of 336f
upper 202, 203f
Abdominal pain 175, 193, 214
left-sided 226
Abdominal wall, anterior 140f, 439
Abiraterone 491
Acanthosis
irregular 483
nigricans 75f, 432, 433, 438f
Achilles tendon region 444f
Achondroplasia 369, 470f
Acne 198
Acral vitiligo 77f
Acromegalic features 258f
Acromegaly 246
clinical features in 251
Acro-osteolysis 381f
Addison's disease 163, 188, 189, 191, 475
Addisonian crisis 189
Adenocarcinoma 303, 303f
Adenohypophyseal tissue 264
Adenoma 184, 245, 264
benign 4
Adipose tissue replacement 96
Adrenal adenoma 167, 193f, 482
diagnosis of 165
left 212f
Adrenal cortex 189
Adrenal cortical hyperplasia 193
Adrenal cyst 217
excision, transperitoneal 216
Adrenal enlargement 164f
Adrenal ganglioneuroma 220
Adrenal gland 161f, 159f, 164f, 183, 193, 214, 216, 222
bilateral enlarged 161f, 191f
disorders of 151
left 167f, 169, 179f, 195f, 212f, 214, 226f
right 171, 175, 191f, 208f
Adrenal hemorrhage, spontaneous 193
Adrenal hyperplasia
congenital 403
nonclassical 482
Adrenal incidentaloma, left 213
Adrenal insufficiency 95, 192, 214
Adrenal lymphomas, primary 215
Adrenal mass
bilateral nonenhancing 222f
left 165f, 169f
right 169f, 201f, 220f, 221f
Adrenal venous sampling 167
Adrenalectomy
laparoscopic right 218
right 176
open 198
Adrenocortical carcinoma 198, 201f, 220
Adrenocortical insufficiency 189
Adrenocorticotropic hormone 154, 163, 168, 214, 232, 238, 260, 266, 276, 290, 403, 475
Adynamic bone disease 328
Alanine 337
Albers-Schönberg disease 385
Albright's hereditary osteodystrophy 390, 435
Albumin 214
Aldosterone : renin ratio 167
Alkaline phosphatase 331, 350, 355
Alkaptonuria, diagnosis of 477
Alopecia 19, 201f, 333f
areata 22
Alström syndrome 433, 435
Ambiguous genitalia 405f, 418, 419, 420f
clinical images of 405
Amenorrhea 198, 301
causes of primary 417
evaluation of 482
hypothalamic 74
primary 406, 417, 418, 423, 466
Amino acid substitution 357
Amphotericin B 159
Amyloid deposits 60f
Amyloidosis 10
Anaplastic cancer, symptom of 63
Anaplastic carcinoma 63, 65f
Anaplastic thyroid cancers 63
Androgen 398
insensitivity syndrome, partial 419
Anemia 222, 258, 387
Ankle
brachial pressure index 134
contracture 466f
joint 446f
right 344f, 359, 367f
X-ray of 446f
Ankle-brachial pressure index 106f
Ankle-foot orthosis 129, 130, 130f
modified 129, 131f
Anosmia 406
Antacids, phosphate-binding 331
Anticardiolipin antibodies 191
Antidiabetic drugs, oral 77, 90
Antiepileptic drug 307
Antihypertensive agents 208
Anti-müllerian hormone 423
Antiphospholipid antibody 163
syndrome 191, 192
Antiplatelet therapy 136
Antirheumatic drugs, disease-modifying 471
Antithyroglobulin antibodies 20
Antithyroid medications 16f
Antitubercular therapy 160, 293
Aorta 9
Aphakic lenses 99f
Arachnodactyly 451f
Arginine 463
Aripiprazole 433
Arnold's face 473f
Arnold's head 474
Arrhythmias 425
Arterial blood
gas 331
supply 193
Arteritis, temporal 241
Artery
disease, peripheral 135f
occlusive disease, peripheral 133, 135f
Arthritis 196f
destructive 425
Articular involvement 196
Artificial prosthesis 137f
Astrocytomas 219
Asymmetric disease 26
Autoimmune
antiphospholipid syndrome 191
candidiasis syndrome 19
diabetes 77
disorders 433
hyperthyroidism 20
thyroid
disease 19
disorders 20
Autonomic failure, hypoglycemia-associated 141
Autonomous adenoma 320
Autopsy 193
Autosomal dominant inheritance 22
Axillas, anterior 455f
B
Babinski sign, bilateral 188
Back pain, low 328
Bacteria, blood culture for 195
Banana fractures 357
Bardet–Biedl syndrome 435
Basal ganglia 338f
calcifications, bilateral 391f
causes for 390
Basal insulin 147
B-cell lymphoma 214
Beaked nose 443f
Below knee amputation 137
Berardinelli–Seip
lipodystrophy 93
syndrome 433
Berutti regimen 198
Bifid scrotum 420f
Bifrontal headache 252, 371
Bilateral adrenal
enlargement 157f, 163, 192f
hemorrhage 193f
hemorrhagic infarct 191
hyperplasia 223f, 264
masses 155f, 222
Bilateral breast 400f
enlargement 400, 414
Bilateral femori 379f
Biliary cirrhosis, primary 485
Biochemical evaluation 224t
Biopsy 326f
Birds’ droppings 160
Bisphosphonate 363
therapy 347
Bitemporal hemianopia 243, 278
Bladder 59
drainage, continuous 46
wall, right lateral 206
Blood
cultures 42
lipid control 136
picture, peripheral 214
Blood glucose 198
levels 483
monitoring devices 138
self-monitoring of 139
Blood pressure 169, 198, 202, 218
control 136, 216
high 191
low 154
Blood–brain barrier 304
Blue sclera 358f, 381f, 384
Body mass index 95, 432, 437, 443
Boggy skin lesions 449f
Böhler iron 130
Bolus insulin 147
Bone
biopsy 350, 350f
cyst, aneurysmal 386
disease 313
infarct 386
marrow biopsy 289, 485
mass
high normal 372f
low 364f
metastases 386, 490
mineral
content 329
density 318, 320, 328, 329, 336f, 353f, 364, 372f
mineralization of 331
morphogenetic protein, abnormal 380
multiple 373
osteosclerosis of 353f, 356f
scan 125, 350
pretreatment 305
scintigraphy 361f, 362f, 386f, 389f
temporal 12
tubular 374
tumor, malignant 361
Bone-destructive lesions 316
Bony deformity 363
Bony metastasis, reduces 491
Bony swelling 445f
multiple 445
Borderline hypernatremia 167
Börjeson–Forssman–Lehmann syndrome 435
Bountiful bone 313
Brain 59, 234f, 236, 247f, 288f, 289f, 291f, 293f, 295f
injury
severe traumatic 238f
traumatic 238
Brainstem 186
Breast 222
carcinoma of 296, 448
development of 407, 419
metastasis from 214
tanner staging of 423
Breathlessness 436
Bromocriptine 272
Buried penis 416
C
Cabergoline 272, 301, 441
high-dose 273
therapy 272
Café-au-lait
macules 347, 448
spots 252, 253f, 254
Calcaneal pitch 123, 126f
Calciopenic rickets 333
Calcitonin 345
staining cells 61f
Calcium 363
Camurati–Engelmann disease 377
Cancer cells 295f
Candida infections 76
Cannon ball lesion 195f
Capillary system 191
Capital femoral epiphysis 359
Carbonic anhydrase 338
Carboxyl ester lipase 90
Carcinoembryonic antigen 61, 177
Carcinoid tumor 219, 448
Carcinoma 264
history of 304
Cardiac myxomas 257
Cardiovascular anomalies 100
Cardiovascular complications 452
Carney complex 257
Carotid artery
aneurysm of 281, 293
left 269f
regions 211f
right internal 271
Carotid body 209
tumors, bilateral 210f
Carpal bones 374
Carpal tunnel syndrome 17
Carpenter's syndrome 22, 435
Cataract, childhood 99
Caudal regression 100f
syndrome 101
Cavernous sinus 240, 276, 279
left 269, 289
right 271
thrombosis 285
Celiac sprue 485
Central diabetes insipidus 299
diagnosis of 305
partial 288
Central hypothyroidism 289
Central nervous system 100, 186
Cerebellar 186
hemangioblastoma 185
hemangiomas 186f
injury, hypoglycemic 441
signs, negative 475
Cerebellum 185, 441
Cerebral
angiography 293
artery, anterior 247
calcifications 338, 338f
damage 238
demyelination 189
Cerebrospinal fluid 233, 236, 250, 270, 285, 289
Cervical
lateral 9
lymph nodes 25f, 44
somite anomalies 423
Charcot arthropathy 115, 124f
investigations for 125
Charcot foot 128f, 130f, 132f
acute 131
bilateral 127f
Charcot restraint orthotic walker 129
Chemotherapy 198, 303
Cherubic face 462f
Chest
hair, decreased 400
wall, anterior 448f
X-ray of 473f
Cholesterol 458
crystals 298
Chondroitin-6-sulfate 469
Chromaffin tissues 206
Chromogranin 459
Chromosome 1Q211 93
Chronic charcot foot, differential diagnosis for 132
Chronic illness
symptom 373
type of 472
Chunky calcification 365f
Cinereum hamartoma 307
Clavicular dysplasia 382
Claw toe 103f, 110, 110f
Cleft lip 370
Cleft palate 370, 411
Cleidocranial dysostosis 474
Cleidocranial dysplasia 474
Clinodactyly 466f
Clitoromegaly 198f, 201f, 417f
Clivus inferiorly 279
Clonidine 463
Coarse facies 99f
Coast of maine 252
Cobalamin 475
deficiency 475
Cohen syndrome 435
Cohesive cell clusters 200f
COL1A1 gene 357
COL1A2 gene 357
Collagenoma 461, 461f
Colloid 36
Colon
carcinoma of 303f
metastasis from 214
Colonic neoplasia 245
Complete renal agenesis 424
Compression fractures 485f
multiple 328f
Conn's syndrome 167
Connective tissues 478
Consciousness, loss of 275
Containing cisplatin 198
Contraceptive pills 417
Cord compression 49f
Corneal leukoma 259
Coronary artery
bypass graft 326
disease 453
Corpus callosum 190f
Corticospinal tracts 190f
Corticosteroids, oral 472
Corticotroph adenoma 279
Corticotropin-secreting tumor 268
Cortisol, urinary-free 264
Costochondral junction 316f
Cough 160
fractures 337
Counterregulatory hormone 459
Coxa valga 469
C-peptide 459
Craniofacial fibrous dysplasia 348f
Craniopharyngioma 281, 297–299
Craniosynostosis 181
Craniotomy, medial frontal 299
Creatine phosphokinase 10
Cretinism 369
Crooke's hyaline 260, 264
Crowe's sign 448
Curvilinear peripheral calcification 39f
Cushing's disease 260–262, 263f, 264, 268
treatment for 261
Cushing's syndrome 168, 208, 223, 225, 260, 264, 266, 439, 440, 471, 475
Cushingoid
face 439, 439f, 471f
habitus 471f
Cutaneous lichen amyloidosis, lesion of 177f
Cutaneous myxomas 257
Cutis vertices gyrate 258, 259
Cyclic adenosine monophosphate 390
Cyst 216f
infection 217
Cysteine 337
Cystic adnexal lesions 480f
Cystic changes 214f
Cystic craniopharyngioma 285
Cystic neck swelling 68f
Cystic papillary serous tumor 223
Cystic parathyroid adenoma 36
Cystic pituitary adenoma 285
Cystic thyroid nodules, majority of 36
Cystic zone 249f
Cystinosis 337
Cystitis 76
Cystoscopy 206
D
Dactylitis 196f
Darling's disease 158
de Quervain's thyroiditis 15, 43
Deafness 370
Dehydroepiandrosterone sulfate 198, 208
Dental fluorosis 352
Deoxyribonucleic acid 98, 176, 419, 438, 457
Desmopressin, oral 304
Dexamethasone 264
oral 417
suppression test 264
Diabetes 80, 425
bronze 425
complications of 78
foot care in 107
foot in 102, 103
footwear in 107
gadgets in 138
generations of 81f
glucose monitoring in 139
insipidus 232, 241, 256, 279, 290, 296, 304, 387
mellitus 88, 91, 183, 245, 303, 433, 434
type 1 22, 74, 81, 99, 139, 141f
type 2 68, 75, 81, 99, 275, 435
Diabetic foot 102f, 119
Diabetic ketoacidosis
diagnosis of 74
history of 91
Diabolical diabetes 71
Diaphyseal dysplasia 259
Diarrhea 487
Diffuse pancreatic lipomatosis, diagnosis of 96
Dihydrotestosterone 419
Distal humerus, left 350f
Distal interphalangeal joint 110
Distal limb anomalies 434
Distal phalangeal acro-osteolysis 382
Distal renal tubular acidosis 337
management of 337
Diverticula 213
Dizziness 272
Dopamine 209, 272
agonists 270, 272
Doubtful sellar mass 264f
Down syndrome 369, 433
Doxorubicin 198
Dry skin 8f, 297
Duchenne muscular dystrophy 10
Dunnigan syndrome 93
Dysgerminomas 302
Dysmorphic facies 357
Dysphagia 30
lesion-like 448
Dyspnea 30
Dysthyroid 25f
ophthalmopathy 26
Dystrophic nails 443, 444f
E
Ear cartilage 477
Easy skin bruisability 168
Ecchymoses 269
Echocardiography 487
Ectodermal dysplasia 447
Ectodermal origin tumors 219
Ectopic gland 7
Ectopic parathyroid adenoma 318
Ectopic thyroid 7
type of 9
Eczema 259
Eggshell calcification 33f, 281
Ehlers–Danlos syndrome 451
Elbow joint 367f
left 367f
X-ray of left 180f
Electrolyte abnormalities 100
Elevated blood pressure 209
Elevated serum triglyceride levels 11
Emphysematous pyelonephritis 76
Empty sella
partially 389f
syndrome 234, 250
Encephalitis 241
Endocrine
abnormalities 298
dysfunction 425
outpatient department 466
system 254
tumors 181
Endosteal proliferation 259
Enterohepatic recycling 272
Enzyme tyrosinase 476
Eosinophilia 214
Eosinophilic granuloma, diagnosis of 386
Ependymomas 219
Epidermal growth factor 269
Epiphyseal plate 359
Episode 218
multiple 97
Epithelioid giant cells 15f
Erdheim–Chester disease 305, 306
Erectile dysfunction 269
Erucic acid 189
Eruptive xanthoma 457
crops of 458f
Erythematous 42f
Erythrocyte sedimentation rate 15
Escherichia coli 42, 76
Estimated visceral adipose tissue 437
Estradiol therapy, low-dose 407
Estrogen 398, 407, 417
receptor modulator, selective 328, 399
resistance 418
Ethmoid sinus
left 340
posterior 279
Etoposide 198
Exostosis, multiple 446f
Extracapsular disease 49f
Extragonadal seminomas 302
Extramedullary hematopoiesis 222
Extraocular muscles 24f
Eye 99
disease 23, 24
prominent 381f, 443f
Eyelid erythema 23
F
Face 406f
hyperpigmentation of 154f
triangular 473f
Facial bones 317
Facial features 445f
Facial hair
absent 359f
growth 425
Facial nerve palsy, left 371
Facial symptoms, development of 251f
Fallopian tubes 403
Familial hypercholesterolemia, diagnosis of 457
Familial partial lipodystrophy syndrome 93
Fat
distribution 92f
mass, increased 437f
Fatty hilum 40f
Feet, high-risk 115
Femoral artery occlusion, left 134f
Femoral neck 359
Femoris, proximal 203f
Femur 357f
both proximal 340f
proximal left 386f
with pencil line cortices 357f
X-ray of 373f
right 388f
Ferriman–Gallwey score 466
Fetal growth, impaired 100
Fetal macrosomia 100
Fever 212
Fibrocalculous pancreatic diabetes 78, 80
Fibrocollagenous tissue 222
Fibrodysplasia ossificans 379
Fibroma, nonossifying 341
Fibrositis 17
Fibrous
dysplasia 252, 254f, 347, 348, 386
stroma 350f
Fibula 347f
Fine-needle aspiration 30, 32, 36, 154
biopsy 58
cytology 15, 30, 42, 60, 158, 175
Fingers and toes, shortening of 381f
Fissure 121f, 122f
story 102f
Fixed ankle brace 129, 130
Flash glucose monitoring system 142f
Flattened vertebrae 369
Fludrocortisone 160, 214, 225
Fluoride intoxication, chronic 352
Fluorosis 352
Foamy macrophages 306f
Focal myositis 10
Follicle-stimulating hormone 232, 238, 239, 278, 283, 285, 293, 297, 299, 301, 307, 309, 359, 363, 406, 411, 414, 416, 417, 421
Follicular neoplasm 33
Fontanel, posterior 474f
Foot
and hands, X-ray of 382f
care program 136
mycetoma of 132f
ulcers, pathobiology of 102
Footwear, sole of 109f
Forearm, X-ray of 353f
Forefoot
pressure 111f
ulcers 111f
Fracture
multiple 357
pathological 51f, 490
risk assessment tool 364, 372
Fredrickson classification 458t
Fused labia-like structure 421f
G
Gadolinium-enhancing mass 209
Gait, abnormal 469
Galactorrhea 239, 406
Galactosemia 337
Gallbladder 9
density 208f
Ganglioneuroma 220
diagnosis of 221
Gangrene 136f
Gastric diverticula 212
Gastrinoma 461f
Gastrointestinal complications 100
Gastrointestinal polyps 254
Gastrointestinal stromal tumor 448
Gastrointestinal tract 184, 222
Gelastic seizures 307
Gene sequencing data 87f, 88f
Genetic disease 181
Genetic disorder 219
Genetic multisystem disorders 435t
Genetic obesity syndromes 435
Genital ambiguity 404, 418
Genitalia
development of 416
external 307
Germ cell tumor 256, 281
Germinoma 302
Gestational diabetes mellitus 86
Gestational trophoblastic disease 195
Giant adenomas 269
Giant cell 154, 306f
idiopathic 291
multinucleated 156f
touton type 305
Giant histiocytes 305
Giant pituitary
adenoma 247
macroadenoma 279
Giant prolactinoma, invasive 269
Giant saccular aneurysm 293
Giant-cell tumor, diagnosis of 173
Giddiness 247
Gigantism 255
Gland 60
hypothalamus 229
parathyroid excision 441
pineal 229
pituitary 229
Glandular tissue
disk of 398
migration of 319
Glibenclamide 86
Glimepiride 77
Glioma, hypothalamic 281
Globulin 214
Glomerular filtration rate 177
Glucagon 463
Glucocorticoid 403
misuse 439
parenteral 232
perioperative 276
therapy, oral 235
Glucokinase mutation 83
Glucometer 138
advantages of 138
limitations of 139
types of 138f
Glucose
levels, uncontrolled 81
monitoring 141f
sensor 140f
monitoring system 140
continuous 139
Glutamic acid decarboxylase 77
Gluteal cleft 455f
Glycated hemoglobin 483
Glycemic control 80, 86, 136, 198
Glycogen storage, abnormal 74
Glycosaminoglycans 27
Glycosylated hemoglobin 75
Gonadectomy 419
Gonadotroph adenoma 276
Gonadotropin-releasing hormone 307, 413
Gower's sign 10
Granulomatous
hypophysitis, causes of 291
inflammation 292f
thyroiditis 15
Graves’ disease 19, 22, 24f, 25f, 26, 27
Graves’ ophthalmopathy 23, 23f–25f, 26, 27f
differential diagnosis for 25
Gross cerebellar atrophy 441f
Gross necrosis 250f
Growth factor
fibroblast-like 342
transforming 377
Growth hormone 236, 238, 248, 249, 309, 461
deficiency 219, 250, 359, 462, 464, 464f
dose of 407
releasing hormone 463
Growth plate 359
Gynecomastia 398, 400f, 401, 414, 421
absence of 419
bilateral 398f, 400, 400f, 402f, 414f
causes for 398, 401
clinical images of 402
drug-induced 398
long-standing 398
painful 402f
surgery, history of bilateral 415f
unilateral 398f
H
Hair loss 19f
Hallux valgus 112, 467
Halo sign 29f
Hamartomas, hypothalamic 307
Hammer toe 110, 110f
Hand, right 17f
Hand–Schüller–Christian disease 305
Hardy's classification system 276
Harris mat assessment 104
Hashimoto's thyroiditis 17, 19, 22, 37f, 38f
Headache 239, 249, 289, 406
chronic 271
episodes of 275
paroxysms of 175
periorbital 208
severe 227
Hearing
aid in situ 343f
defect 467
loss 97, 343
Heart 9
anomalies, congenital 467
failure 425
failure symptoms, right 487
valves 273
Heel wedges 115
Hemangioma 186f
Hemangiopericytoma 341
Hematologic problems 100
Hematuria 168
episode of 205
painless 185
Hemochromatosis 95
primary 475
Hemodialysis 359
Hemogram 165
Hemorrhage
adrenal 193
intracystic 217
intratumoral 227
subarachnoid 293
Hemorrhagic infarction 240
Hepatic fibrosis 435
Hepatocyte nuclear factor 90
Hereditary fructose intolerance 337
Hereditary hemochromatosis 425
Heterotopic ossification 379f
HFE gene 425
High-arched
foot 115f
palate 97, 451, 452f
Hindfoot 122f
Hirsutism 198, 198f
Histiocytes 42, 285
Histiocytosis 288, 305
Histoplasma 160, 162
capsulatum 155, 157, 160
Histoplasmosis 214, 222
capsulatum 159
disseminated 159
Hoffmann's syndrome 10, 11
Holocranial headache 243, 275
Homogentisic acid 477, 478
Hormonal hypersecretion 221
Hormone
deficiency 241
replacement therapy 236
Hounsfield units 212
HRPT2 gene mutations 327
Human chorionic gonadotropin 301
Human growth hormone 266
Human immunodeficiency virus 157
Human leukocyte antigen 20
Human prolactin 301, 307
Humerus, left 202
Hydrocortisone, parenteral 154, 192
Hyoid bone, level of 66
Hyperaldosteronism, primary 167
Hypercalcemia 441, 490, 491, 492f
Hyperchloremic metabolic acidosis 339
Hypercortisolemia 74, 271
Hyperextensible joints 451, 451f
Hyperglobulinemia 42
Hyperglycemia 74, 75, 141f, 467
Hyperglycemic hyperosmolar nonketotic coma 75
Hyperinsulinemia 433
Hyperinsulinemic hypoglycemia 441
Hyperintense
lesion 9, 9f
mass 171f
Hyperlipoproteinemias 458t
Hypernatremia 304
Hyperostosis 371f, 378
Hyperostosis-hyperphosphatemia syndrome 361
Hyperparathyroidism, primary 180, 318, 325
Hyperphagia, history of 436
Hyperphosphatemia 492f
Hyperpigmented ear lobule 478f
Hyperpigmented macule 177
Hyperpigmented plaques 432
Hyperplasia 184, 459
Hypertelorism 466f
Hypertension 168, 206
control of 216
Hyperthyroidism 4
Hypertriglyceridemia 11, 457
Hypervascular lesions, multiple 488f
Hypoadrenal crisis 440
Hypoalbuminemia 483
Hypocortisolemia 233, 283
Hypodense space-occupying lesion 442f
Hypoechoic lesion 256
left-sided 42f
small 421
Hypoechoic thyroid 44
Hypoechoic vascular lesion 209
Hypoglycemia 245, 322, 459, 462, 463
asymptomatic episodes of 142f
Hypoglycemic symptoms 460
Hypogonadism 398, 467
Hypokalemia 198
Hyponatremia 232
Hypophosphatemic osteomalacia 342f
Hypophosphatemic rickets 334f
Hypophyseal stalk 291
Hypoplastic clavicles 473, 473f
Hypoplastic mandible 447
Hypotension 272
Hypothalamic-pituitary-adrenal axis 260, 440
Hypothalamus, region of 308f
Hypothyroidism 425
congenital 5, 12
primary 9, 480
severe 481
Hypovascular myxoid stroma 351f
I
Ichthyosis 8f
Idiopathic calcinosis cutis 492f
clinical image of 492
Iliac bone metastases 179
Incidental adrenal cysts, treatment of 217
Infections 163
Infertility 100
Infiltrative dermopathy 28f
Inflammatory bowel disease 485
Inflammatory disorders 15
Inflammatory neck mass 68
Inflammatory pituitary lesion 289
Inherited diabetes and deafness syndrome 98
Innominate artery 68
dilatation, right 68f
Insufficiency fractures 198
Insulin 42, 145f
administration 144
deficiency 99
delivering devices 138, 144
gene 90
promoter factor 85, 90
pump 140, 146f
secretion of 459
store 76
syringe 144f, 145
Insulin pen 144f, 145f
device 144
advantages of 145
Insulin resistance 95
assessment of 92
severe 94f
Insulin resistance syndromes
type A 433
type B 433
Insulin therapy 85
intensive 74
Insulinoma 441
Intact parathyroid hormone 325
Intellectual disability 5
Intensity-modulated radiation therapy 299
Interdigital web space infection 113
Intermittent fever, history of 160
Intermittent headache, history of 165
Internal carotid artery 266, 277, 279
Internal jugular vein, left 61f
Interosseous membrane calcification 335f
Interphalangeal joint 17f, 196f, 369
proximal 110
Intervertebral disk calcification 478f
Intracerebral hematoma 241
Intracranial germinomas 302
Intracranial hypertension 288
benign 236
idiopathic 236
Intracranial pressure 232, 236, 276
Intracranial tension 462
Intramuscular myxoma 350
Intramuscular testosterone 309, 421
Intraocular pressures 305
Intrasellar pressure 233
Intravenous analgesics 78
Intravenous fluids, bolus of 74
Intravenous octreotide therapy 196
Irinotecan 303
Iris, nodules in 449f
Ischemic necrosis 241
Itraconazole 160
J
Jaundice 462
Jaw, osteonecrosis of 330f
Joint
aspiration 128
effusion 17
large 347f
movements 366
stiffness 17
K
Keratinocytes 476
Ketosis 74
Kidney 186, 222
disease, chronic 320, 355, 366
Klebsiella pneumoniae 76
Klinefelter syndrome 411, 413, 414, 416
clinical images in 415
diagnosis of 414
Klippel–Feil anomaly 424
Knee joint 446f
Knock knees 333f
Knosp classification 276
Köbberling syndrome 93
Koch's disease 291
Kocher–Debré–Semelaigne syndrome 10
Kyphoscoliosis 332f, 469
L
Labia majora, right 419f
Lachrymal gland tumors 26
Lactate dehydrogenase 214
Langer's mesomelic dysplasia 409
Langer–Giedion syndrome 445
diagnosis of 445
Langerhans cell 389
histiocytosis 386, 389
Laron dwarfism 465
Laron syndrome 465
Laryngeal neoplasms 196
Laurence–Moon syndrome 435
Left femur
end of 386f
fracture of 51
Left foot
deformity of 123f
X-rays of 123f
Lentigines, multiple 406f, 409f
Leonine facies 258
Léri–Weill dyschondrosteosis 409
Lesion
heteroechoic 192
multiple 195f
Letter– Sieve disease 305
Leucine 337
Leukemia 296, 448
Levothyroxine supplements 369
Leydig cell tumors 482
Liddle's test 264
Limbs 92t
Lingual thyroid 9, 9f
Lipemia 457f
Lipemic serum 11f
Lipid-rich adenoma 167f
Lipodystrophic disorders 94
Lipodystrophy 93f
Lipomastia 398
Lipomatous pseudohypertrophy 96
Lipoprotein
cholesterol, low-density 444
intermediate-density 458
low-density 453, 458
Lips, hyperpigmentation of 188
Liver 59
function test 165, 459
Lmna gene mutations 93
Lobstein syndrome 357
Long bones, deformity of 355f
Looser's zones 336
Loperamide 487
Lower limb 49, 96, 357
right 347
Lucent lesions, multiple 349f
Lumbar spine 46f, 346f
Lumbosacral spine, X-ray of 375f
Lung 222
left 159f
metastasis 58f, 214
parenchyma 178f
upper lobes of 155f
Luteinizing hormone 232, 238, 239, 244, 275, 278, 283, 285, 297, 301, 309, 363, 399, 416, 425, 481
Lymph node 35f
enlargement 66
metastases 48, 49f
normal 40f
Lymphadenopathy 30
Lymphangitis carcinomatosa 303f
Lymphedema, bilateral 8f
Lymphocytes 18f, 42, 285
Lymphocytic hypophysitis 290
diagnosis of 288
Lymphocytic infiltrate, chronic 335
Lymphohistiocytic infiltrate 483
Lymphoma 26, 222, 296
diagnosis of 215
disseminated 214
primary 214
Lymphoproliferative disorders 288
Lytic lesion 59, 347f, 388f
Lytic-sclerotic skull 348f
M
Madelung deformity 409
Madura foot 132f
Malabsorption syndromes 485
Malleolus, lateral 122f
Mallet toe 110, 110f
Marble bone disease 384
Marfan syndrome 451, 452
Marfanoid body habitus 184
Marfanoid habitus 175, 181, 363
Marie and Sainton disease 474
Masquerades, miscellaneous 429
Mass
abdominal 174
adrenal 181
calcified 281f
enhancing irregular 177
heterogeneous 175f, 209
pedunculated 342f
suprasellar 301f
Massive hepatosplenomegaly 487f
Massive thyroid swelling 32f, 37f
Maternal drug ingestion 403
Maturity-onset diabetes of young 81, 89
characterization of 90t
gene defects 83
Mauriac syndrome 74
Mayer–Rokitansky–Küster–Hauser syndrome 418, 423, 424
McCune–Albright syndrome 248, 252, 253f, 264, 347, 349f
Meary's angle 123, 126f
Medial arch support 115f
Mediastinal nodes 52f
Mediastinal widening, anterior 320f
Mediastinum 9, 222
Medical therapy 131
Medullary nephrocalcinosis, bilateral 336f
Medullary thyroid carcinoma 60, 61, 176, 179, 181, 184
Melanocytes 476
Melanoma 296
Melorheostosis 373
Memory, history of loss of 278
MEN1 syndrome 461f
MEN2B phenotype 181
Menin gene 322
Meningioma 219, 296, 302
Menstrual cycles
irregular 432
normal 480
Mental retardation 5, 94, 434, 435, 447
Mercury poisoning 475
Metabolic abnormalities 94, 100
Metabolic acidosis 331
Metabolic disorders 429
Meta-iodobenzylguanidine 169, 170f, 172f, 173f, 175, 175f, 179f, 183, 195, 196f, 203f, 204f, 205, 206f, 208, 208f, 209
scan 209f
therapy 202
Metanephrine level 171
Metastasis 45f, 46f, 173, 296, 303f, 352, 355
Metastatic breast cancer, management of 330
Metastatic disease 53, 179, 204
evaluation of 61
Metastatic neck 52f
Metatarsal pad 110, 111f
Metatarsophalangeal joint 110
Metformin 77, 86, 444
Methylene diphosphonate bone 305
Microadenoma 261f
left 260
Microcellular rubber 105f, 108
footwear 108f, 117f, 118f
Microconidia 155
Microphallus 462
Microsomal triglyceride transfer protein 457
Micturition 206
Midfoot ulcers 114f
Midnight serum cortisol 261
Midshaft femur, right 389f
Midshaft sclerosis, bilateral 362f
Milkman's fracture 336
Mipomersen 457
Miscellaneous disorders 429
Mitochondrial diabetes 99
Mitogen-activated protein kinase 53
Mitotane 198
Mitral valve prolapse 451
Molded shoes 115
Monofilament test 104f
Moon face 260f
Morquio syndrome 369, 468
Mucocutaneous candidiasis, chronic 19
Mucopolysaccharidoses 468, 470f
Mucosa, oral 154
Mucosal hyperpigmentation 154f
Mucosal neuroma 176, 181, 182f
Müllerian duct 423
aplasia 423
Müllerian hormone 423
Müllerian structures 421
Multinodular goiter 4, 29, 56
Multiple dental abscesses 334f
Multiple endocrine
deficiency 19
neoplasia 61, 169, 176, 179, 181, 184, 322, 441, 461
Multiple rib 202, 203f, 350f, 389f
fractures 331f
Multiple tendon xanthomas 454f
Muscle
atrophy, severe 443f
hypertrophy 11
hypotonia 370
weakness 167, 168
Mutational dysostosis 474
Myalgias 17
Myasthenia gravis 19, 22
Myasthenic syndrome 10
Mycobacteroum tuberculosis, dissemination of 163
Myelolipomas 168
Myeloma
cells 486f
multiple 485
Myocardial infarction 457
Myopathic disorder 10
Myopathy 316
Myopia 370
Myositis 17
Myxedema 17
Myxomas 351
N
Nasal bridge, depressed 5f
Nausea 191, 272
Neck
left side of 65f
mass, congenital 68
nodes, right-sided 44f
Necrolytic migratory erythema 483, 484, 484f
Necrotic tissue 161f
Nelson's syndrome 266, 268, 475
Neoplasms 362
Neoplastic disorders 68
Nephrocalcinosis, bilateral 335, 335f
Nerve root 186
Nesidioblastosis 459
Neural foramina 173f
Neuroblastoma 220
Neuroendocrine tumor 177, 196, 226
Neurofibromas, type of 448
Neurofibromatosis 218, 219, 450f
Neurofibromin 219
Neurofibrosarcomas 219
Neurogenic
differentiation 88, 90
symptom 459
Neuroglycopenic symptom 459
Neurotropic tyrosine kinase receptor 54
Neutrophils 15f, 42
NF1 gene 169
Night blindness 434
Nocturnal ventilation 438
Nodular branching 154f
Nodular hyperplasia 225
Nodular lesions, multiple 195f
Nonendocrine organs 254
Nonfunctional pituitary
macroadenoma 279
tumor 250, 281
Non-Hodgkin's lymphoma 214
Nonhomogeneous opacity 303
Non-Langerhans cell 305
Nonlymphocytic leukemias 219
Nonpitting edema 27
Nonsteroidal anti-inflammatory drugs 15, 259, 373
Nonsurgical therapy 129
Normetanephrine 171, 208
Normocalcemia 340
Nyctalopia 434
Nystagmus 411
O
Obesity 433
Obstructive pulmonary disease, chronic 485
Obstructive sleep apnea 436
Ochronosis 478
Octreotide, long-acting 483
Ocular motility, disorders of 240
Odontoid hypoplasia 469
Odors, types of 411
Odynophagia 157
Olfactory bulb 412f
bilaterally 412f
Oligomenorrhea, history of 239
Oncogenic osteomalacia 342, 342f
Oophorectomy, right-sided 223
Ophthalmopathy 24f, 25f
Ophthalmoplegic migraine 241
Optic atrophy 372
bilateral 384
Optic chiasmal compression 302
Optic glioma 281
Optic nerve 236, 289
Oral contraceptive pills 268, 407
Orbital tumors, primary 26
Ornithine 337
Orphan Annie eye nuclei 46f
Osmotic symptoms 85
Osseous metastases 203f, 204f
Osteitis fibrosa 316
cystica 316
disseminata 252
Osteogenesis imperfecta 357, 358
Osteolytic region 343
Osteomalacia 352, 332f
tumor-induced 341
Osteomyelitis 116f, 135, 361, 362
Osteonecrosis 330, 361
Osteopathia striata 375
Osteopenia 331f, 363f
Osteopetrosis 384
Osteopoikilosis 374
treatment of 374
Osteoporosis 328, 329f, 363, 444, 485
idiopathic juvenile 363
prevention of 419
Osteosclerosis 338f
diffuse 384f
Ovarian hyperstimulation syndrome 481
diagnosis of 480
Ovarian hyperthecosis 482
Ovarian mass 223, 480
Ovarian steroid cell tumors 482
Overnight dexamethasone suppression test 260
Oxidized glutathione 476
P
Pachydermoperiostosis 258
Paget's disease 337, 343, 345, 352, 355, 384
juvenile 361
Pain
causes 373
debilitating 491
severe 490
Palmar creases 154, 154f, 163f
Palmar freckling 449f
Palmar xanthoma 457, 458f
Palpable gonads 419
bilateral 405f
Palpation, abdominal 206
Palpitation 175, 191
paroxysms of 171
Pancreas 9, 96, 186, 442f
multiple cysts in 185f
parts of 80
Pancreatic cysts 185
multiple 187
Pancreatic duct 80f
Pancreatic enzyme supplements 95
Pancreatic inflammation 78
Pancreatic parenchyma, replacement of 95
Pancreatitis, acute 318
Panhypopituitarism 299
Paper grip test 105f
Papillae 67f
Papillary
carcinoma 51
craniopharyngiomas 298
thyroid cancer 45, 53, 59
Papular lesions, multiple 160
Paragangliomas 203
left 226
Parahypothalamic region 307
Paralytic ileus 227
Paraneoplastic polyarthritis 196
Pararenal fascia 75
Parasellar region 267f
Parathyroid
disease 313
hormone 316, 318, 340, 355, 361
hyperplasia 320
scintigraphy 321f, 322, 326f
tissue 319f
Parathyroid adenoma 183, 183f, 184, 324
diagnosis of 318
right 183f, 321f
inferior 320
Parathyroid carcinoma 327
primary 326f
Parathyroid gland 322
region 323f
Parathyroidectomy 320
right 184
Parental consanguinity, history of 417
Paresthesias, painful 97
Parietal bones 252
Parinaud syndrome 302
Pars tuberalis 283
Patchy osteosclerosis 335f
Patellar tendon 131f
bearing orthosis 130
modified 130f
Patrick Yesudian sign 449f
PAX4 gene 89
PDX1 gene 85
Pectus carinatum 371, 452f, 468f, 469
Pectus excavatum 448f, 452
Pedigree chart 83, 85, 86f, 88, 89f, 91f
Pelvic bone 202, 203f, 490f
Pelvis 205f, 317, 374
anteroposterior 332f
X-ray of 360f, 367f, 368f, 446f, 478f
Pemberton's sign 42, 60, 60f
positive 32f, 38f
Penoscrotal hypospadias 420f
Percutaneous radiofrequency thermal ablation 483
Periodic acid-Schiff 160
Periodontal disease 258
Periosteal proliferation 259
Periosteal reaction 361f
Periventricular region 188f
Personal genome machine 82
Pes cavus 114, 115f
Pes planus 114
Pheochromocytoma 165, 169, 173, 181, 182f, 184, 203, 206, 208, 220, 226, 448
adrenal 209
diagnosis of 206
right 185
Phosphate
levels 365
solution, oral neutral 334f
Phosphaturia 318, 341
Phosphaturic mesenchymal tumor 341, 342f
Phosphopenic rickets 334
Pinch test 109f
Pituitary abscess 285
Pituitary adenocytes 250
Pituitary adenoma 240f, 248, 250, 269, 293
functional 276
with apoplexy 240f
Pituitary adenomectomy 261
Pituitary apoplexy 242, 242f, 249, 266, 285, 293
Pituitary autoantibodies 290
Pituitary dysfunction 293
Pituitary gigantism 248
Pituitary gland 12, 235, 260, 261f, 262f, 264f, 269, 289, 290f, 296, 304
anterior 296
autoimmune inflammation of 290
normal 240
posterior 296, 304, 309
small 425, 426f
Pituitary hormone
concentrations 238
deficiency, signs of multiple 462
dysfunction 288
secretion 238
Pituitary hyperplasia 12
Pituitary hypofunction 285
Pituitary insufficiency 403
Pituitary macroadenoma 246f, 249f, 256f, 276, 281
Pituitary metastases 296, 304
Pituitary microadenoma 223, 263f, 441f
Pituitary passions 229
Pituitary pseudotumor 12, 14
Pituitary region 295f
Pituitary stalk 298
interruption syndrome 309
thickening 288
Pituitary stone 281, 297f
Pituitary surgery 232
Pituitary thyrotroph hyperplasia 14
Pituitary tissue 272
normal 223, 250
Pituitary tumor 261, 268, 304, 322
Pituitary-thyroid axis 236
Plantar pressure assessment 104
Plasma
adrenocorticotropic hormone 198
cells 42, 163, 285
glucose 459
random 75, 441
Plasmacytoma, X-ray in 486
Plaster of Paris 117f
Platelet destruction, peripheral 179
Platyspondyly 469
Podiatrists 107
Polyarthritis 196
Polycystic ovarian syndrome 433
Polydipsia 303, 305
Polyglandular autoimmune syndrome 10, 77
Polygonal tumor cells 459
Polyuria 303, 304
Poor glycemic control 97
Porphyria 475
Portable infrared dermal thermometry 128
Postacute phase 129
Post-meta-iodobenzylguanidine 203f
Postpartum hemorrhage, history of 234
Postpartum pituitary necrosis 235
Post-Synacthen stimulation test 188
Post-thyroidectomy scar 181f
Post-traumatic panhypopituitarism 238
Potassium, normal 266
Prader-Willi syndrome 435, 438, 438f
Preablation iodine 22
Prednisolone 225, 279, 290, 305, 309
oral 252
Pre-Synacthen adrenocorticotropic hormone 191
Pretibial myxedema 27f
Progesterone pill 417
Progressive proximal myopathy 316
PROK2 genes 413
Prolactin 238, 269
secretion 269
Prolactinoma 245, 269, 274, 441
Prophylactic thyroidectomy 180
Propranolol 463
Proptosis
bilateral 305f
symptoms of unilateral 16f
unilateral 26f
Prostate 296
Prostatic cancer 491
Protein
C 191
S 191
Proteinuria 222
nephrotic-range 216
Proton pump inhibitor 78, 401
Proto-oncogene mutations 176
Psammoma body 49f
Psammomatous melanotic schwannoma 257
Pseudoachondroplasia 369
Pseudofractures 336, 337
diagnoses for 337
Pseudogynecomastia 398
Pseudohyponatremia 75
Pseudohypoparathyroidism 435
Pseudotumor cerebri 236
Psychiatric disorders 99
Ptosis
asymmetric bilateral 22f
bilateral 19f
recovery of 242f
Pubertal growth spurt 462
Pubertal gynecomastia 398
Pulmonary artery dilatation 452
Pulmonary disease 100
Pulmonary infection 163
Pulmonary valve regurgitation 487
Pyknodysostosis 381, 382
Q
Quadriparesis, recurrent 335
R
Rabson-Mendenhall syndrome 433
Radiation therapy, postoperative 270
Radiofrequency ablation 327f
Radionuclide therapy 209
Rathke's cleft cyst 281, 283, 285
Rathke's pouch 283
Recurrent episodes of syncope 441
Red blood cells 240
Refractory seizures 307
Regular menstrual cycles 318, 417
Rehabilitation 238
Renal carcinoma, right 187f
Renal cell carcinoma, low risk for 186
Renal complications 100
Renal cyst 86f
bilateral multiple 185f
multiple 185f
Renal disease, end-stage 317
Renal dysplasia 423
Renal focal segmental glomerular sclerosis 98
Renal function
normal 347
tests 165
Renal images, absent 352
Renal involvement 434
Renal mass, bilateral 185
Renal osteodystrophy 352, 355
treatment of 355
Renal pelvis 76
Renal tubular acidosis 337f, 352, 355
Reproductive adnexal organs 186
Residual pituitary
adenoma 266
function, normal 250
lesion 244f
Residual tumor 266, 267f
management of 299
Resistant rickets 333f
Respiratory tract infections 445, 447
RET gene 169
Retina 186
Retinal detachment 370
Retinal hemangioblastomas 186
Retinitis pigmentosa 435
Retroareolar fat tissue 400f
Retrobulbar neuritis 241
Retroperitoneal sarcoma 220
Rhabdomyolysis 10f
Rhabdomyosarcoma 219, 448
Rheumatic diseases 17
Rheumatoid arthritis, juvenile 471
Rheumatoid factor 17
Rhinorrhea 233
Rib 317
lower 468f
metastasis to 180f
osteopenic 331f
tumors in 325f
Rocker-bottom
foot deformity 125, 127f
sole 112f
anterior 111
Round-to-spindle cells 342f
Rubinstein-Taybi syndrome 435
Rugger-Jersey appearance 352
Rupture 217
S
Sabouraud's dextrose agar 162
Sacral bone, right 200f
Sacral metastasis 46f
Sacrum 173, 374
right 198
Sandwich appearance 384f
Sanger's sequencing chromatogram 82f, 84f, 87f, 88f, 93f
Sarcoidosis 26, 288
Scalp hair, loss of 443f
Scheuthauer–Marie–Sainton syndrome 474
Schmidt's syndrome 22
Sclera 477
Sclerosis, extensive 352f
Sclerosteosis 372
Sclerotic clusters, multiple 374f
Sclerotic lesion 347f, 386f
Scooped insole 119f
SDHAF2 gene 169, 203
SDHB gene 169
mutations 174
SDHC gene 169
SDHD gene 169
Secreting pituitary
adenoma 256
macroadenoma 244
Sella turcica 236, 295
mass 276
Sella, J-shaped 468f
Sellar aneurysm 293
Sellar extension 296
Sellar fossa 245f
Sellar mass 14f, 249, 275f, 285, 301f
Sellar regions 278f, 281f
Semmes–Weinstein monofilament test 103
Sensors, types of 105
Sensory testing, quantitative 103
Septate mass, large 43f
Sertoli cell tumor 257
Sertoli–Leydig cell tumor 482
Serum
albumin 390
aldosterone 167
alkaline phosphatase 338, 491
elevation of 320
calcitonin 177
calcium 183, 320, 355, 361, 363, 365, 390
normal 347
cortisol 198, 214, 260, 261, 269, 276, 299
creatinine 216
growth harmone 465
human prolactin 232, 234
insulin 244
luteinizing hormone 400
phosphate 183
phosphorus, low 340
sclerostin 372
testosterone 283, 293, 411, 419, 482
thyroglobulin 47
estimation 45
Sestamibi-parathyroid 322f
Sex development, disorder of 421
Sexual characters, secondary 473
Sexual differentiation, disorder of 395, 418
Sexual dysfunction 289
Sexual maturity 307
Sheehan's syndrome 234, 235
Short stature 5, 12, 12f, 16f, 403f, 436f, 467, 469, 471f
SHOX gene 409
Sickle cell
crisis 361
preparation 361
Silver methenamine 160, 161f
Simultaneous serum insulin 459
Single cell type 240
Sinus 261
absent frontal 474f
sphenoid 279
thrombosis 241
Sinusitis, sphenoid 285
Sistrunk's operation 51
Sjögren's syndrome 17, 335, 337
Skeletal deformities 452, 470f
Skeletal diseases 339
Skeletal fluorosis 352, 355
Skin 9, 59, 222
changes 4
hyperpigmentation 475
lesion 432
rash 387
temperature 107
Skull
and humerus, X-rays of 383f
and neck swellings 58f
X-ray of 382f
SLC29A3 gene 467
Slipped capital femoral epiphysis 359
Small cell lung cancer 490
Smoking cessation 136
Snake bite 359f
Soft-tissue
and skin 244
calcification 444, 444f
density mass 63f
enhancing 202
swelling 365f
Solid right adnexal lesion 482f
Somatostatin receptor-positive neuroendocrine tumor, treatment for 204
Sparse pubic hair 401f
Speech, discomfort in 157
Sphenoid bone, right 388f
Spiking fever 42
Spinal cord 186
compression 490
Spinal ligament, anterior 352, 352f
Spine 186f, 335f
termination of 101
X-ray of 328f, 332f, 379f
Spironolactone 401
Spleen, hyperplasia of 254
Spondyloepiphyseal dysplasia 369, 370
congenita 370
treatment of 370
Squamous papillary 299
Stalk thickening 288
Staphylococcus species 43
Steatorrhea 78
Stereotactic radiosurgery 245, 252, 299
Steroid
and fludrocortisone replacement 191
cell tumor 482
oral 439
Stiffness 370, 373
Stomach 212
Streptococcus species 43
Stretched penile length 416
Subcapsular plexus 193
Subhyoid complex cystic lesion, midline 66f
Submental neck swelling 66f
Succinate dehydrogenase 210
Sudden unexplained deaths 202
Sulfonylureas 81
Supra sternal notch 4, 47, 49, 52
Suprapubic region 201f
Suprarenal mass
left 226
right 172f, 209f
Suprarenal region
left 168f, 170f, 216
right 170f, 172f, 175f, 218f
Suprasellar
extension 275f, 296
mass 249, 285
region 278f, 281f, 297
Suprasternal notch 46
Supratentorial hemangioblastomas 186
Supraumbilical region 201f
Surgical therapy 131
Suspicious pituitary microadenoma 223f
Swelling 27, 361
multiple 35f
subcutaneous 379
Sympathetic ganglia 169
Sympathetic nerves 206
Symptomatic tumors 168
Syndromic diagnosis 322
Syringes 144
Systemic sclerosis 492f
T
Tall stature 414f
Tarsal bones 374
Technetium bone 354f
Technetium-99m bone scan 127f
Teeth
discoloration of 358f
irregular 447
mottling of 352f
radiography of 358f
Tenderness 361
Tendinous xanthoma 453
Tendon xanthoma 453, 457
Teratoma, adrenal 220
Teriparatide 328
Terrific thyroid 1
Testes, left 256, 257f
Testicular tissue 421
Testicular tumors 398
Testosterone 198, 269, 293, 399, 433
levels 404
therapy 413
Tetracycline 355
Thiamine 441
Thoracic spine 477, 485f
X-ray of 468f, 478f
Thoracic vertebra 49
Thoracolumbar spine 369, 485
Thorax 155f, 180f
Thrombocytopenia 179, 387
Thyroglossal cyst 7, 66, 67
Thyroid 15f, 32f, 36f, 39f, 40f, 47f, 57f, 175, 222
acropachy 28f
anlage 9
architecture, normal 18f
bed 7
carcinoma of 177
cartilage 67
deficiency, long-standing 12
dermopathy 28f
disease, clinical variations in 8
Doppler studies of 41
illnesses, diagnosis of 43
left lobe of 4f, 43f, 44
lobectomy 63
malignancies 41f, 65, 65f
mass, right 64f
nodule 33f, 39f, 43
normal 39f
papillary carcinoma of 49f, 67, 67f
parenchyma 42
region 45
right lobe of 29, 36
scintigraphy 5, 6f, 7f, 49f
surgery, old 181
tumor 45
ultrasonography of 38
ultrasound of 36f, 40f
whole body 57f
Thyroid cancer 53, 63
differentiated 63
management of 56
Thyroid function 266
test 66, 266, 269, 278, 307
Thyroid gland 1, 15, 42, 67, 320
large 32
normal 66f
Thyroid hormone
free 276
replacement 12
suppression 45
Thyroid swelling 29, 29f, 37, 42, 60f, 63f
bilateral 37f
diffuse 17f, 38f
malignant 35
unilateral 37f
Thyroid tissue 33
normal 65
Thyroidectomy
completion 184
probable subtotal 32, 181
right 176
total 45, 51, 61
Thyroiditis
acute suppurative 42
chronic 4
Thyroid-stimulating hormone, 7, 12, 14, 15, 17, 20, 47, 232, 238, 239, 244, 278, 283, 291, 299, 307, 444, 475, 480
Thyroidzectomy 56
Thyrotoxicosis 475
Thyrotropin-releasing hormone 269
Thyroxine 12, 252, 279, 281
levels, total 7
low free 7
oral 271, 299
replacement therapy 406
supplementation 302
withdrawal 45, 47
Tibia 347f
expansile lesion in 350f
left 361f, 373f
midshaft of 377f
Tibial cortex 337f
Tissue
affected 305
responses, types of 155
Toe
cap 110f
separator 113f
sleeve 110f
Tongue 66, 157f, 159f
enlargement 243, 258f
lesion, biopsy of 159
mucosal neuroma of 181f
protrusion of 65f
Tonic-clonic seizures 295
Total contact cast 119
Total pancreatic lipomatosis 96
Toxic metabolites 210
Trachea 60f, 63
Tracheal invasion 61
Transcutaneous oxygen measurement 136
Transmetatarsal amputation 137f
Transsphenoidal adenomectomy 264
Transsphenoidal surgery 270
Trauma, history of 443
Trichorhinophalangeal syndrome 445
Triglycerides 458
Triiodothyronine 239, 299
Tru-cut biopsy 65f
Truncus arteriosus 424
Trunk 92t
Tuberculoid granulomas 155
Tuberculosis 195, 214, 222, 289
Tuberous xanthoma 453
Tumor 262f
benign 168, 220
brown 320
cells 206f
growing 168
multiple brown 321f
primary 204f
proliferative index 279
resection, laparoscopic 206
suppressor
gene 210
protein 322
with liver, primary 203f
Tumoral calcinosis 365, 366, 367f
X-ray in 367
Turner stigmata 421
Turner syndrome 408f, 418
clinical images in 408
diagnosis of 406
Tyrosinase
activates 476
catalyzes 254
Tyrosine, hydroxylation of 254
Tyrosinemia 337, 478
U
Ulcer 102f, 114f, 157f
forefoot 109
healed 119f, 122f
hindfoot 115, 116f, 121f
midfoot 113
nonhealing 118f, 120f, 134f
oropharyngeal 158
pathophysiology of 102f
stump with 137f
trophic 135f
Upper arm, right 448f
Upper limb 136f
Ureteric orifice, right 206
Urinary bladder 205f
Urinary catecholamine 209
Urinary cortisol 260
Urinary metanephrine 206, 218, 226
normal 208
Urinary osmolality 303
Urinary tract infections 75
Urine 75, 477f
catecholamines 176
culture 76
metanephrines 176
Uterine
development 407
transplant 423
Uterus 403
absent 423
V
Vagina 403
Vaginal depth, correction of 419
Valvulopathy 273
van Buchem disease 372
Vanillylmandelic acid 205
Vascular lesion, large 195f
Vascularity, peripheral 33f, 41f
Vertebra 352, 375f, 490f
anterior 468f
Vertebral body 344f
collapse 49f
Vertebral fracture assessment 363
Vertebral metastasis 52f
Very low-density lipoprotein 458
VHL gene 169
Virilizing tumors 482
Vision
diminution of 301
worsening of 237
Visual acuity 278
Visual defects 406
Visual deterioration 243
Visual disturbances 249
Visual evoked potential 188, 384
Visual field 240, 299
symptoms 299
Visual impairment, severe 241
Visual symptoms 298
Vitamin
B1 441
B12 95, 441
deficiency of 475, 476
C, hyperdose of 478
D 331, 333f, 363, 390
deficiency 320, 331, 332
injection 78
insufficiency 473
supplementation 333f, 352
Vocal cord dysfunction 30
Voglibose 77
Vomiting 191, 208, 239, 247, 275
von Hippel–Lindau disease 185
von Recklinghausen's disease 316
Voorhoeve syndrome 375
W
Weight gain 22, 160, 208, 269
progressive 220
Weight loss 212
unintentional 163
Werner syndrome 444
Wernicke's encephalopathy 441
Wolffian ducts 423
Wrist, X-ray of 308f, 471f
X
X chromosome, abnormal 406, 414
Xanthelasma 457
bilateral 457f
Xanthoma tuberosum 453
Z
Zellballen appearance 172f, 173f
Zinc deficiency 484f
Zoledronic acid 343, 357, 365
×
Chapter Notes

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Clinical Atlas in ENDOCRINOLOGY & DIABETES: A Case-based Compendium
Clinical Atlas in ENDOCRINOLOGY & DIABETES: A Case-based Compendium
SECOND EDITION
Editors Nihal Thomas MBBS MD (Gen Med) MNAMS DNB (Endo) FRACP (Endo) FRCP (Edin) FRCP (Glas) FRCP (London) FACP PhD (Copenhagen) Professor and Head, Unit-1 Department of Endocrinology, Diabetes and Metabolism Christian Medical College, Vellore, Tamil Nadu, India Felix Jebasingh K MBBS MD (Gen Med) DM (Endo) DNB (Endo) PGDMLE (Med Law) Associate Professor Department of Endocrinology, Diabetes and Metabolism Christian Medical College, Vellore, Tamil Nadu, India Mathews Edatharayil Kurian MBBS Medical Research Officer Department of Endocrinology, Diabetes and Metabolism Christian Medical College, Vellore, Tamil Nadu, India Foreword Ashley Grossman
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Clinical Atlas in Endocrinology and Diabetes: A Case-based Compendium/ Nihal Thomas, Felix Jebasingh K, Mathews Edatharayil Kurian
First Edition: 2016
Second Edition: 2022
9789389587302
Printed at
This book is dedicated to our teacher, Professor (Dr) M.S. Seshadri, all the staff of the Department of Endocrinology, Diabetes and Metabolism at Christian Medical College, Vellore and our patients and clients, from whom we have learned in abundance.
We would also like to thank Dr Simon Rajaratnam, former head of the department for his support and guidance.
Editors
Associate Editors
Contributors
Chapter 1: The Terrific Thyroid
Chapter 2: Diabolical Diabetes
Chapter 3: Aggressive Adrenal
Chapter 4: Pituitary Passions
Chapter 5: Bountiful Bone
Chapter 6: Reminiscences in Reproduction
Chapter 7: Miscellaneous Masquerades
Foreword
Endocrinology is a very visual specialty. While, as always, a good and detailed history is essential, probably in no other specialisation other than perhaps dermatology is the physical appearance of patients more vital in coming to a correct diagnosis. Patients with Cushing's syndrome and acromegaly, in particular, have languished for years before the diagnosis was suspected and treatment instituted, and in many other areas recognition of clear clinical features is either ignored, missed, or misattributed. In diabetes, many of the changes over time, particularly those due to a variety of complications, require careful clinical inspection and recognition in order to initiate prompt and often life-saving interventions. Furthermore, both diabetes and endocrinology are increasingly dependent on accurate interpretation of radiological imaging, be it with ultrasound, CT scanning, MRI or radionuclide scanning. It is therefore of great importance that we focus on the visualisation of all aspects of endocrinology and diabetes, and their complications. It is in the light of these considerations, that these authors published their initial atlas some years ago, and it is due to the clear success of this project that I am now delighted to welcome a second edition. As before, it is very much based on the concept of a case-based approach, which has been shown to be an ideal manner to aid the trainee doctor and help educate even experienced clinicians in sharpening their clinical skills, and so assisting in patient management.
As I previously noted in my foreword to the first edition, it is especially fitting that this dual approach of teaching endocrinology and diabetes by highly visual techniques and case-based studies comes from the Christian Medical College in Vellore, as one of the most highly praised and accomplished medical centres in Tamil Nadu, India. With both a stellar national and indeed international reputation, the Department of Endocrinology, Diabetes & Metabolism has put together a beautifully illustrated and highly instructive colour atlas, assisted by extensive collaboration with many other clinical departments. The illustrations remain outstanding, the text is clear and informative, and the success of the first edition implies that it has indeed been highly educative and useful.
I am delighted to introduce this new edition and, as originally suspected, it is indeed set to become a standard reference in Endocrinology and Diabetes.
Ashley Grossman FMed Sci
Professor of Endocrinology
Green Templeton College
University of Oxford
and Centre for Endocrinology
Barts and the London School of Medicine
Queen Mary University of London, UK
Preface to the Second Edition
Half a decade has elapsed, and the world has transformed itself during this phase. Nevertheless, clinical endocrinology remains relevant. Creative and analytical thinking should perpetually be the foundation of clinical medicine. The role of visual stimulation in guiding our thought processes is essential to the means of analysis.
We continue to engender this process in the evolution of the second edition of our clinical atlas in endocrinology. A big thank you to the faculty and the residents who have managed these patients.
Dr Felix has continued to spread his academic visage to ensure that the book coruscates and vibrates with a tinge of novelty. Dr Mathews has worked many late hours to make sure that this compendium has reached fruition.
As your fingers slide between the pages, we hope that this time of learning will be enlightening and enrapturing.
Bonne Lecture!
Nihal Thomas
Preface to the First Edition
Endocrinology is a specialty which encompasses a wide spectrum of disorders. Disorders of thyroid, diabetes, obesity, and osteoporosis involve nearly 30% of the population at a random time point in life. This book focuses on the need of the practicing clinician—whether primary care, physician, surgeon or Endocrine specialist to handle and identify endocrine problems.
I would like to thank and acknowledge the hard work and dedication that Dr Felix Jebasingh K has put into developing several areas of the book. I would like to also appreciate the multidisciplinary impact of several medical specialties across the board in supporting this endeavor.
Just as much this expedition is meant to aid in improving patient care, and support the academician in their learning endeavors, the case discussions and evaluations provided may have a long-term impact on learning processes.
Bonne Lecture!
Nihal Thomas
Acknowledgments
Endocrinology is a specialty which involves teamwork.
The multidisciplinary overlap between several clinical and non-clinical units is a strong feature of the subject. This book would not have been possible but for the strong academic links that the Department of Endocrinology shares with several other departments in the hospital. The care for patients is foundational for such a lucid output.
We would also like to thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr MS Mani (Group President), Dr Richa Saxena (Associate Director, Professional Publishing), Ms Himani Pandey (Development Editor), Ms Seema Dogra (Cover Visualizer), and Production Team of Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India.
Nihal Thomas
Felix Jebasingh K
Mathews Edatharayil Kurian