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CONDITION/DISORDER SYNONYMS

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  • Acquired Hypoparathyroidism

  • Autoimmune Hypoparathyroidism

  • Congenital Hypoparathyroidism

  • Idiopathic Hypoparathyroidism

  • Familial isolated hypoparathyroidism (FIH)

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ICD-9-CM CODES

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  • 252.1 Hypoparathyroidism

  • Associated ICD-9-CM PT diagnoses/treatment diagnoses that may be directly related

    • 315.4 Developmental coordination disorder

    • 718.45 Contracture of joint, pelvic region and thigh

    • 719.70 Difficulty in walking involving joint site unspecified

    • 728.2 Muscular wasting and disuse atrophy not elsewhere classified

    • 728.89 Other disorders of muscle, ligament, and fascia

    • 729.9 Other and unspecified disorders of soft tissue

    • 780.7 Malaise and fatigue

    • 781.2 Abnormality of gait

    • 782.3 Edema

    • 786.0 Dyspnea and respiratory abnormalities

    • 786.05 Shortness of breath

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ICD-10-CM CODES

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  • E20.0 Idiopathic hypoparathyroidism

  • E20.1 Pseudohypoparathyroidism

  • E20.8 Other hypoparathyroidism

  • E20.9 Hypoparathyroidism, unspecified

  • E89.2 Postprocedural hypoparathyroidism

  • P71.4 Transitory neonatal hypoparathyroidism

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PREFERRED PRACTICE PATTERNS1

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  • 4D: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated With Connective Tissue Dysfunction

  • 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated With Localized Inflammation

  • 6B: Impaired Aerobic Capacity/Endurance Associated With Deconditioning

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PATIENT PRESENTATION

A 30-year-old female marathon runner referred to physical therapy with complaints of lower extremity (LE) cramping and tingling in her feet, limiting her ability to compete. She also described feeling short of breath as she struggles to increase distances again. There is no history of injury. In the course of casual conversation, she also complains of her nails breaking more than usual with her manicures not lasting more than a few days. Her boyfriend told her that her “legs were looking skinny” and observation reveals sarcopenia in her calves. The skin on her feet is dry and pealing, but she stated they have a tendency to be dry. She has started a reconditioning program in PT which is not responding well. Although referred by an orthopedist to PT, she is scheduled for an annual physical with her primary doctor in the next few weeks. The PT has suggested discussing her signs and symptoms with her physician and has offered to give her a summary of her PT to be brought to him.

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FIGURE 28-1

Levels of immunoreactive parathyroid hormone (PTH) detected in patients with primary hyperparathyroidism, hypercalcemia of malignancy, and hypoparathyroidism. Boxed area represents the upper and normal limits of blood calcium and/or immunoreactive PTH. (From SR Nussbaum, JT Potts, Jr, in L DeGroot, JL Jameson, eds. Endocrinology. 4th ed. Philadelphia, PA: Saunders; 2001, with permission.)

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FIGURE 28-2

Anatomic relations of the thyroid gland, anterior view. The blue structures are the thyroid gland and the course of the obliterated thyroglossal duct. (From LeBlond RF, DeGowin RL, Brown DD. DeGowin’s Diagnostic Examination. 9th ed. http://www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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