The Achilles Reflex in Thyroid Disorders (1964)

Article1 August 1964The Achilles Reflex in Thyroid DisordersA Critical EvaluationFRANK Q. NUTTALL, M.D., RICHARD P. DOE, M.D.FRANK Q. NUTTALL, M.D., RICHARD P. DOE, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-61-2-269 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn spite of the plethora of thyroid function tests currently available to the clinician, only two tests represent measurements of end-organ or tissue response to changes in thyroid function. These are the basal metabolism rate (BMR) and the serum cholesterol test. Both are rather non-specific and subject to great error. They usually rank low among tests of thyroid function. The desirability of having a more specific and direct measure of the peripheral effect of thyroid hormones is obvious. The slowing of reflexes has long been held in esteem by clinicians as a near pathognomonic sign in myxedema. The brisk reflex...References1. WERNER SC (editor): The Thyroid, 2nd Edition. Harper and Row, New York, 1962, p. 639. Google Scholar2. ORD WM: Address in medicine: on some disorders of the nutrition related with affection of the nervous system. Brit. Med. J. 2: 205, 1884. CrossrefMedlineGoogle Scholar3. HOUSTON CS: The diagnostic importance of the myxedema reflex (Woltman's sign). Canad. Med. Ass. J. 78: 108-112, 1958. MedlineGoogle Scholar4. CHANEY WC: Tendon reflexes in myxedema: A valuable aid in diagnosis. JAMA 82: 2013-2016, 1924. CrossrefGoogle Scholar5. MUSSIO FOURNIER JC: Trastornos del sistema nervioso de origen mixedematoso, in Estudios de Clinical Medica. "Casa A. Barreiro y Ramos" S.A., Montevideo, 1929, pp. 29-32. Google Scholar6. HARRELLDANIEL GTD: Delayed relaxation of tendon reflexes as an aid in the diagnosis of myxedema. N. Carolina Med. J. 2: 549-551, 1941. Google Scholar7. LAMBERTUNDERDAHLBECKETTMEDEROS EHLOSLO: A study of the ankle jerk in myxedema. J. Clin. Endocr. 11: 1186-1205, 1951. CrossrefGoogle Scholar8. LAWSON JD: The free Achilles reflex in hypothyroidism and hyperthyroidism. New Eng. J. Med. 259: 761-764, 1958. CrossrefMedlineGoogle Scholar9. GILSON WE: Achilles-reflex recording with a simple photomotograph. New Eng. J. Med. 260: 1027, 1959. CrossrefMedlineGoogle Scholar10. SMARTROBSON GAAM: A simple method for recording Achilles tendon reflexes. Lancet I: 363, 1963. CrossrefGoogle Scholar11. SHARPE AR: A simple isotope method for recording the Achilles tendon reflex in myxedema. J. Lab. Clin. Med. 57: 165-166, 1961. Google Scholar12. BINSWANGERSTUDERWYSS VJHF: Der Ablauf der sehnenreflexe bei funktionsstorungen der schilddruse. Helv. Med. Acta 4: 482-486, 1961. Google Scholar13. WEISSBEINLAWSON ASJD: Paradoxical lengthening of muscle contraction time in hypothyroid patients given small doses of L-triiodothyronine, thyroxine and desiccated thyroid. J. Clin. Endocr. 20: 429-435, 1960. CrossrefGoogle Scholar14. FOGELEPSTEINSTOPAKKUPPERMAN RLJAJHHS: Achilles tendon reflex test photomotogram) as a measure of thyroid function. New York J. Med. 62: 1159-1168, 1962. MedlineGoogle Scholar15. TUDHOPEWILSON GRGM: Deficiency of vitamin B12 in hypothyroidism. Lancet I: 703-706, 1962. CrossrefGoogle Scholar16. DAVISCAMFIELDHERMANGOLER TECJRHD: Thyroid function in patients with aspermiogenesis and testicular tubular sclerosis. New Eng. J. Med. 268: 178-182, 1963. CrossrefMedlineGoogle Scholar17. NICKELFRAME SNB: Nervous and muscular systems in myxedema. J. Chronic Dis. 14: 570-581, 1961. CrossrefMedlineGoogle Scholar18. GROB D: Myopathies and their relation to thyroid disease. New York J. Med. 63: 46-56, 1963. Google Scholar19. SHERMANGOLDBERGLARSON LMFC: The Achilles reflex: A diagnostic test of thyroid dysfunction. Lancet I: 243-245, 1963. CrossrefGoogle Scholar20. SIMPSONBLAIRNARTOWIZ GMJHGR: Prolonged Achilles reflex in neurosyphilis simulating the "myxedema reflex." New Eng. J. Med. 268: 89-91, 1963. CrossrefMedlineGoogle Scholar21. SIMPSONBLAIRNARTOWICZ GMJHGR: Diagnostic limitations of Achilles tendon reflex in thyroid disease. New York J. Med. 63: 1148-1153, 1963. MedlineGoogle Scholar22. DEGENNESDESCHAMP LH: Reflexogramme Achilleen, test de la fonction thyroidienne. Presse Med. 69: 1543-1545, 1961. MedlineGoogle Scholar23. LAWSONWEISSBEIN JDAS: The effect of parenteral vitamin B12 on muscle contraction in hypothyroidism. Ame. J. Med. Sci. 239: 77-82, 1960. CrossrefMedlineGoogle Scholar24. GOLDBERG M: Comparative study of the adrenergic potentiating properties of various thyroid analogs in man. J. Clin. Endocr. 22: 892-899, 1962. CrossrefGoogle Scholar25. AVERAOVERHOLT JWBM: Achilles tendon reflex relaxation time: An aid in diagnosis and management of thyroid disorders. Amer. Pract. 13: 251-254, 1962. Google Scholar26. LEEBRONSKYWALDSTEIN WYDSS: Studies of thyroid and sympathetic nervous system interrelationships. II. Effects of guanethidine on manifestations of hyperthyroidism. J. Clin. Endocr. 22: 879-855, 1962. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: FRANK Q. NUTTALL, M.D.; RICHARD P. DOE, M.D.Affiliations: Minneapolis, MinnesotaFrom the Medical Service, Minneapolis Veterans Administration Hospital, and the Department of Medicine, University of Minnesota, Minneapolis.This work was supported in part by Public Health grant CA-05371, United States Public Health Service, Bethesda, Maryland 21214.Requests for reprints should be addressed to Richard P. Doe, M.D., Chief, Metabolic Section, Veterans Administration Hospital, Minneapolis, Minnesota 55417. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEffect of l-Thyroxine Replacement Therapy on Surrogate Markers of Skeletal and Cardiac Function in Subclinical HypothyroidismThyroid Insufficiency. 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RIVES, M.D., EUGENE D. FURTH, M.D., DAVID V. BECKER, M.D. 1 August 1964Volume 61, Issue 2Page: 269-288KeywordsAnemiaCholesterolHospital medicineMedical servicesPrevention, policy, and public healthProteinsReflexesThyroidThyroid diseasesThyroid hormones ePublished: 1 December 2008 Issue Published: 1 August 1964 PDF downloadLoading ...