Definition
The condition that results from inadequate secretion of
thyroid hormones during fetal life or early infancy. The brain and
skeleton fail to develop properly, resulting in mental retardation
and dwarfism.
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Radiographic Appearances
In cretinism, the base of the skull is foreshortened, the
face is wide and short, the mandible underdeveloped, and the maxilla
overdeveloped. This can be identified both clinically and with
lateral cephalometric radiographs. The eruption of primary and
permanent teeth is delayed.
The long bones may be thickened and short, the epiphyses appear late
and are often irregular and deformed.
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Pathology
Cretinism is a condition of stunted body growth and impaired mental
development. The symptoms, which appear during early infancy, are
the gradual development of a characteristic coarse, dry skin, a
slightly swollen face and tongue, umbilical hernia, and an open
mouth that drools. The baby is usually listless, slow-moving,
constipated, and a slow feeder. Cretinism is the result of a
congenital deficiency in the secretion of the hormone thyroxine from
the thyroid gland. In some cases, this is thought to be caused by an
insufficient amount of iodine in the diet of the child's mother
during pregnancy. Thyroid testing on newborns to detect cretinism is
now a routine test in many countries.
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Treatment:
Treatment with thyroid hormone promotes normal physical and mental
development. It is essential that treatment be started during the
first six weeks of life or irreversible changes may take place. |
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