Role of the Ankle-jerk in the Diagnosis and Management of Thyroid Disease

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Abstract
The ankle-jerkhas been measured with the method described by Smart and Robson. The results recordedfrom 131 subjects gave a normal range of 145-230 msec, and 240-340 msec, for the tap-to-peak and tap-to-half-relaxation measurements respectively. The ankle-jerk times obtained in 165 patients with thyroid disease are compared with an independent clinical assessment and with the neck uptake of radioactive iodine (interpreted in conjunction with the protein-bound radioactive iodine). Both the contraction and the relaxation phases of the ankle-jerks are affected by hormones, either measurement being equally satisfactory for use in the assessment and management of thyroid disease. This is illustrated by reference to the jerk times in a patient with thyrotoxicosis, in one with panhypopltuitarism, and 3 normal subjects after the administration of triiodothyronine. The limitations of the test are discussed, and it is concluded that the test is a simple inexpensive way of diagnosis and the only objective means, apart from the B.M.R., [basal metabolic rate] of assessing response to treatment.