Acromegaly

Frontal radiograph of the hand demonstrates widening of the terminal tufts (between long arrows), bases of the distal phalanges, thickening of the digit soft tissues (between arrowheads) and widening of the metacarpophalangeal joints (between short arrows).

Facts: Acromegaly

• Acromegaly = large extremities
• Syndrome caused by hypersecretion of growth hormone (GH) secondary to pituitary adenoma, or hyperplasia.
• GH hypersecretion leads to different skeletal manifestations depending on patient's age.
• In mature skeleton (like in our patient), there is increased bone width and soft tissue enlargement particularly in the acral parts of the skeleton.
• Complication: secondary osteoarthritis

Imaging

• Soft tissues: thickening of the digits, enthesopathy
• Bones: bone enlargement, squaring of phalanges and metacarpals, spade-like terminal tufts
• Joints: widening of joint spaces due to thickening of articular cartilage

Reference:

Guglielmi G, Van Kuijk C, Genant HK. Fundamentals of hand and wrist imaging. Springer-Verlag 2001.