BONE CHANGES OF CONGENITAL HYPOTHYROIDISM:

1)retardation of osseous development (60%)

2)absent distal femoral epiphyses
3)dicrepancy betweem chronological age and osseous development
4)epiphyses multiple foci of calcification (epiphyseal dysgenesis)
5)beaking of T12/L1/L2
6)xray head : large ant and post fontanelle
7)intersutural bones (wormian bones)
8)sella turcacia large/erosed and thin
9)delayed dentition due to delayed teeth formation and eruption
10)depressed nasal bridged
11)broad carpals and small phalanges of hands gives broad hands and short fingers
12)muscular pseudohypertrophy particularly of calf muscles , more in boys giving athletic
appearance , cause unknown.

DD's FOR WORMIAN BONES (RK - CHOPS)

R: rickets
K: kinky hair syndrome
C:cleidocranial dystrophy
H:hypopara/hypothyroi/hypophostemic rickets
O:osteogenesis imperfecta
P:pycnodysostosis
S:syndromes (eg Down's)

DD's FOR EPIPHYSEAL DYSGENESIS: (SSE)

Skeletal: MPS/pseudoachondroplasia
Syndromes: Stickler syndrome/bardet biedel syndrome/conorenal syndromes.
Endocrine:hypothyroidism