Articular Manifestations of Acromegaly

Podgórski, Maciej; Robinson, Bruce G.; Weissberger, Andrew J.; Stiel, J. N.; Wang, S.; Brooks, P. M.

doi:10.1111/j.1445-5994.1988.tb02236.x

Cited by 58 publications

(35 citation statements)

References 28 publications

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“…In a review of 45 case notes and 20 patients with acromegaly, 22% male and 36% female patients were moderately to severely disabled by their arthropathy (8). A good response to treatment, assessed clinically and by growth hormone (GH) estimation, was associated with better employment and less severe joint disease.…”

Section: Introductionmentioning

confidence: 99%

Impact of musculoskeletal disease on quality of life in long-standing acromegaly

Miller¹,

Doll²,

David³

et al. 2008

European Journal of Endocrinology

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Objective: To provide rheumatological assessment of patients with long-standing acromegaly and investigate the impact of musculoskeletal disease on quality of life. Design: Cross-sectional observational study. Methods: Fifty-eight patients diagnosed with acromegaly at least 5 years previously were interviewed and examined by a rheumatologist. Each patient completed the short form-36 (SF-36), arthritis impact measurement scales 2 (AIMS2) and acromegaly quality of life questionnaires (AcroQol). Results: Fifty-two out of 58 (90%) reported musculoskeletal pain, with 29 (50%) reporting neck pain. Hip osteoarthritis was present in 49 (84%) and knee osteoarthritis in 20 (34%). Half the patients (52%) reported sleep disturbance, but only 2 (3.5%) had fibromyalgia. Ten (17.2%) had previously undergone carpal tunnel decompression. Fifty-one (88%) patients had consulted their general practioner and 31 (54%) complementary therapists. SF-36, AIMS2 and AcroQol scores were lower in patients with musculoskeletal pain. Conclusions: This study of musculoskeletal problems in patients with acromegaly reports systematic rheumatological examination, use of medical services and quality of life scores. Musculoskeletal problems should be routinely addressed in acromegaly by both endocrinologist and rheumatologist and a multidisciplinary approach taken to management.European Journal of Endocrinology 158 587-593

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Section: Introductionmentioning

confidence: 99%

Impact of musculoskeletal disease on quality of life in long-standing acromegaly

Miller¹,

Doll²,

David³

et al. 2008

European Journal of Endocrinology

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“…UCT is the cause of disability and pain for patients and, in extreme cases, may progress to loss of function of the hand (4). In the clinical practice, sensory disturbances typically affect acromegalic patients' hands, but the majority of investigations deal with median nerve involvement (1)(2)(3)(4)(5). In particular, Jenkins et al elegantly demonstrated by magnetic resonance imaging that the predominate pathologic mechanism of median neuropathy in acromegaly seems to be edema of the perineural sheathes rather than increased volume of the carpal tunnel contents (5).…”

Section: Introductionmentioning

confidence: 99%

“…Carpal tunnel syndrome (CTS) is a common complication of acromegaly occurring in 20-64% of patients at diagnosis (1,2). Sensory disturbances in the hand of acromegalic patients may derive from a generalized nerve swelling that involves the median nerve and the ulnar nerve (3).…”

Section: Introductionmentioning

confidence: 99%

The pathology of the ulnar nerve in acromegaly

Tagliafico¹,

Resmini²,

Nizzo

et al. 2008

European Journal of Endocrinology

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Context: Acromegalic patients may complain of sensory disturbances in their hands. Cubital tunnel syndrome, the ulnar nerve neuropathy at the cubital tunnel (UCT), in acromegalic patients has never been reported. Objective: To describe and assess the prevalence of UCT in acromegalic patients and the effects of 1 year of therapy on UCT. Patients: We examined prospectively 37 acromegalic patients with no history of polyneuropathy, acute trauma at the elbow, no diabetes or hypothyroidism with clinical examination, nerve conduction studies (NCS), and high-resolution ultrasound (US). A control group was made by 50 volunteers. The local ethics committee approved the study and written informed consent was obtained from all subjects involved in the study. Intervention: Clinical history, physical examination, NCS, and US were used to diagnose UCT at the beginning of the study and after 1 year.

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“…11,16,17 Arthralgia is seen in 70% of patients in the early period and frequently takes the form of large joint involvement. 2,8 In our study, arthralgia was present in 13 patients (34.2%).…”

Section: Discussionmentioning

confidence: 91%

“…2,3 Pain generally occurs due to the stimulating effect of GH and IGF-1 on cartilage and bone. 4 Peripheral nerve problems are also common among acromegaly patients and ensue secondary to either neural growth itself or external soft tissue/bony compression.…”

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confidence: 99%

Ultrasonographic Assessment of Soft Tissues in Patients With Acromegaly

Koçak¹

2015

Arch Rheumatol

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Objectives: This study aims to investigate ultrasound examination findings of cartilage, tendon and nerve structures in patients with acromegaly and assess whether imaging findings have any association with the clinical and laboratory features of the patients. Patients and methods:The study included 38 diagnosed acromegaly patients (18 males, 20 females; mean age 45.6±10.4 years; range 28 to 63 years) and 21 control subjects (8 males, 13 females; mean age; 43.1±7.4 years; range 29 to 58 years) similar for age, sex and body mass index. Patients' clinical characteristics and laboratory parameters were recorded. The cross sectional area of median nerve, flexor pollicis longus and Achilles tendon, and humeral cartilage thickness were bilaterally assessed by ultrasound. Results: Arthralgia was present in 13 patients (34.9%) and 11 (28.9%) had paresthesia in the hands. Thickness of humeral cartilage and the cross sectional area of median nerve, flexor pollicis longus tendon and Achilles tendon was significantly higher in acromegaly patients compared with controls (p<0.001). While measurements performed with ultrasound were correlated among themselves, no significant correlation was present between ultrasound measurements and growth hormone and insulin-like growth factor-1. When acromegaly patients were analyzed as active (n=22) and inactive (n=16), no significant difference was determined in the parameters with the exception of median nerve measurements. Conclusion: Ultrasound examination revealed significantly different cartilage, tendon and nerve parameters in acromegaly patients compared to the control group. Median nerve cross sectional area was significantly greater in active patients compared to inactive patients.

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Articular Manifestations of Acromegaly

Cited by 58 publications

References 28 publications

Impact of musculoskeletal disease on quality of life in long-standing acromegaly

Impact of musculoskeletal disease on quality of life in long-standing acromegaly

The pathology of the ulnar nerve in acromegaly

Ultrasonographic Assessment of Soft Tissues in Patients With Acromegaly

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