There is also an increased risk of bone fractures (by 42%) in people with subclinical hyperthyroidism; there is insufficient evidence to say whether treatment with antithyroid medications would reduce that risk.A 2022 meta-analysis found subclinical hyperthyroidism to be associated with cardiovascular death. Screening
In those without symptoms who are not pregnant there is little evidence for or against screening. Treatment
Antithyroid drugs
Thyrostatics (antithyroid drugs) are drugs that inhibit the production of thyroid hormones, such as carbimazole (used in the UK) and methimazole (used in the US, Germany and Russia), and propylthiouracil. Thyrostatics are believed to work by inhibiting the iodination of thyroglobulin by thyroperoxidase and, thus, the formation of tetraiodothyronine (T4). Propylthiouracil also works outside the thyroid gland, preventing the conversion of (mostly inactive) T4 to the active form T3. Because thyroid tissue usually contains a substantial reserve of thyroid hormone, thyrostatics can take weeks to become effective and the dose often needs to be carefully titrated over a period of months, with regular doctor visits and blood tests to monitor results.A very high dose is often needed early in treatment, but, if too high a dose is used persistently, people can develop symptoms of hypothyroidism. This titrating of the dose is difficult to do accurately, and so sometimes a "block and replace" attitude is taken. In block and replace treatments thyrostatics are taken in sufficient quantities to completely block thyroid hormones, and the person treated as though they have complete hypothyroidism.
The clinical appearance and the characteristic radiographic are important to confirm the diagnosis. Treatment
Children who develop severe bowing before the age of 3 may be treated with knee ankle foot orthoses. However, bracing may fail, or bowing may not be detected until the child is older. Bracing should be started by 3 years of age. In some cases, surgery may be performed.Blount disease is one of the 8 severe comorbidities of severe obesity (BMI >35), which are an indication for bariatric surgery in children per a 2019 policy statement of the American Academy of Pediatrics. The other severe comorbidities are: obstructive sleep apnea (Apnea-Hypopnea Index > .5), Type2 Diabetes mellitus, idiopathic intracranial hypertension (IIH), nonalcoholic steatohepatitis, SCFE, GERD, and hypertension. References
External links
Dakshina Murthy T S. S; Alessandro De Leucio. Blount Disease Treasure Island (FL): StatPearls Publishing; 2022 Jan-.