Labels:text | screenshot | black and white | black | font | document OCR: graph Thyroid Fig 23.50b Thyroid acropachy: hand rad showing periosteal reaction and clubbin e and acropachy occurs as part of Graves' dise s, usually consists of clubbing of the fingers and to ial associated with exophthalmos and preti sarily part myxoedema. Bone changes are not nece ently of the syndrome although they are freq nd first present. The coned view of the thumb ic lace-like metacarpal demonstrates the characteri ides the appearance of the periosteal reaction. Be al, typical involvement of the first metaca occur periosteal new bone formation may als the along the shafts of other metacarpals an ht proximal phalanges. In this patient, a sl he shaft of periosteal reaction is also present along the proximal phalanx of the thumb, See also: . Graves' sease