The Journal of Bone and Joint Surgery, Vol 63, Issue 3 405-410, Copyright © 1981 by Journal of Bone and Joint Surgery, Inc
Multiple endocrine neoplasia with skeletal manifestations
JA Carney, AJ Bianco, GW Sizemore and AB Hayles
There are three types of familial multiple endocrine neoplasia, but type
2b, which is characterized by medullary thyroid carcinoma,
pheochromocytoma, and ganglioneuromatosis, is the only one in which
patients also have skeletal anomalies. These musculoskeletal abnormalities
include marfanoid habitus, pes cavus, talipes equinovarus, slipped capital
femoral epiphysis, kyphosis, scoliosis, lordosis, increased joint laxity,
and weakness of the proximal muscles of the extremities. Affected patients
have several facial abnormalities as well, the most striking being
enlargement of the lips. Therefore, when a patient is seen with one or more
of these musculoskeletal defects, the diagnosis of type-2b multiple
endocrine neoplasia should be considered. If the characteristic facial
features of the disorder are present, the patient should have a prompt
examination for medullary thyroid carcinoma and pheochromocytoma.