Endocrine Abnormalities Affecting the Musculoskeletal System

Abstract

Several endocrine disorders may affect the musculoskeletal system altering bone metabolism and growth. The pituitary gland produces growth hormone (GH): it increases longitudinal height during childhood, promotes mineralization of bone and determines muscle mass hypertrophy. An oversecretion of GH leads to acromegaly and gigantism. GH deficiency leads to pituitary dwarfism. The thyroid gland secretes triiodothyronine (T3) and thyroxine (T4). They stimulate endochondral ossification, linear growth and maturation of the epiphyseal ossification centres and influence the bone turnover. Both hyperthyroidism and hypothyroidism may determine alterations in the musculoskeletal system. The parathyroid glands produce parathormone (PTH). It strictly regulates calcium and phosphate blood levels. It stimulates osteoclasts to break down bone and release calcium. It also induces maturation of osteoclasts from their precursors. In the kidneys, PTH promotes calcium resorption, phosphate release and activation of vitamin D. Hyperparathyroidism and hypoparathyroidism are two conditions that dramatically affect the locomotor system. The adrenal glands secrete aldosterone, cortisol and androgens. Abnormal adrenal hormone production may result in Cushing’s syndrome (overproduction of cortisol), Addison’s disease (primary adrenal insufficiency) and many other conditions that also affect the musculoskeletal system.

This chapter highlights the effects of the most common endocrinopathies on the locomotor system.